Determining Key Organizational Health Communication Practices in Complex Patients

确定复杂患者的关键组织健康沟通实践

基本信息

批准号：
9253778
负责人：
Kerri Cavanaugh
金额：
$ 14.22万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-04-01 至 2020-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9253778
关键词：
Address Administrator Advocacy Age Behavior Benchmarking Blood Vessels Caring Cessation of life Characteristics Clinical Cohort Studies Communication Communication Research Complex Country Development Dialysis procedure Dietitian Dimensions Discipline Educational Activities End stage renal failure Ensure Environment Epidemiology Evaluation Frequencies Future Goals Health Health Communication Health Personnel Health Status Health system Healthcare Healthcare Systems Hemodialysis Hospitalization Incentives International Intervention Leadership Life Measurement Measures Medical Methodology Methods Monitor Nephrology Nurses Outcome Patient Care Patient Outcomes Assessments Patient-Centered Care Patient-Focused Outcomes Patients Pattern Perception Personal Satisfaction Phenotype Physicians Process Provider Quality of life Race Reporting Research Research Infrastructure Research Personnel Resources Role Self-Examination Social Sciences Social Workers Specific qualifier value Surveys System Technology Testing Training Programs Trust United States Centers for Medicare and Medicaid Services Variant clinical care cohort experience health care quality health literacy high risk improved improved outcome individual patient mortality multidisciplinary novel novel strategies operation patient oriented patient population payment programs prospective

项目摘要

DESCRIPTION (provided by applicant): Effective communication is an essential component of patient-centered care. Emerging evidence suggests that favorable organizational communication, or the health communication practices within and between constituents of a healthcare system, is essential to the delivery of high quality, reliable and safe patient- centere care. Advancing research to determine the relationship between organizational communication and patient outcomes is necessary and critical to promote the integration of communication assessment into routine health system self-evaluation and quality monitoring. The goal of this proposal is to advance the assessment and understanding of the practices, determinants and associated patient outcomes of health- related organizational communication practices. End-stage renal disease (ESRD) and the provision of life- sustaining dialysis treatment provides a unique and robust environment to examine dialysis facility organizational communication and its impact on patient outcomes. Patients with ESRD are at significantly higher risk for mortality, hospitalization, and poor quality of life. Despite advances in the technology of dialysis care, outcomes are persistently poor indicating opportunities for novel strategies to improve patient healthcare. Overall, we hypothesize that organizational communication contributes significantly to individual patient outcomes, facility-level quality metrics, and also may overcome disparities in outcomes among vulnerable patient populations. As part of this proposal we will leverage the resources of the Dialysis Outcomes and Practice Patterns Study (DOPPS), a representative prospective international cohort study since 1996, in 21 countries, aimed to identify modifiable practices associated with improved patient outcomes. To address our hypothesis, the aims of this proposal are: 1) To characterize the quality of organizational communication in dialysis facilities by adapting, administering and validating an existing measure in 100 facilities and 700 hemodialysis patients; 2) To examine in a prospective cohort the association of organizational communication with clinical and patient-reported outcomes in 465 dialysis facilities and 15,000 patients worldwide; and 3) To determine if dialysis facility organizational communication modifies associations of age, race, or health-literacy related disparities and clinical or patient-reported outcomes. We are an integrated, diverse research team well equipped and uniquely poised to efficiently leverage existing infrastructure to significantly advance health communication research. Importantly, we are also connected to a deep network of national and international resources to ensure dissemination of our findings to a broad audience. This research will serve future research by advancing methodology of communication assessment and also our understanding of mechanisms of organizational communication in dialysis care. Most importantly, this research will inform the future development and testing of efficient and effective multi-level interventions to connect patients, providers and health systems to optimize quality programs and patient-centered care.

描述（由申请人提供）：有效的沟通是以患者为中心的护理的重要组成部分。新的证据表明，良好的组织沟通，或者医疗保健系统各组成部分内部和之间的健康沟通实践，对于提供高质量、可靠和安全的以患者为中心的护理至关重要。推进研究以确定组织沟通与患者结果之间的关系对于促进沟通评估纳入常规卫生系统自我评估和质量监测至关重要。该提案的目标是促进对健康相关组织沟通实践的实践、决定因素和相关患者结果的评估和理解。终末期肾病（ESRD）和维持生命的透析治疗的提供提供了一个独特而强大的环境来检查透析机构的组织沟通及其对患者结果的影响。 ESRD 患者的死亡、住院和生活质量差的风险明显更高。尽管透析护理技术取得了进步，但结果仍然不佳，这表明有机会采取新策略来改善患者医疗保健。总的来说，我们假设组织沟通对个体患者的治疗结果、设施水平的质量指标有显着贡献，并且还可以克服弱势患者群体之间治疗结果的差异。作为该提案的一部分，我们将利用透析结果和实践模式研究 (DOPPS) 的资源，这是一项自 1996 年以来在 21 个国家开展的具有代表性的前瞻性国际队列研究，旨在确定与改善患者结果相关的可修改实践。为了解决我们的假设，该提案的目标是： 1) 通过在 100 个机构和 700 名血液透析患者中调整、管理和验证现有措施来描述透析机构中组织沟通的质量； 2) 在前瞻性队列中检查组织沟通与全球 465 个透析机构和 15,000 名患者的临床和患者报告结果的关联； 3) 确定透析机构的组织沟通是否会改变年龄、种族或健康素养相关差异与临床或患者报告结果之间的关联。我们是一支综合性、多元化的研究团队，装备精良，具有独特的优势，能够有效利用现有基础设施来显着推进健康传播研究。重要的是，我们还与国家和国际资源的深层网络相连，以确保将我们的研究结果传播给广大受众。这项研究将通过推进沟通评估方法以及我们对透析护理中组织沟通机制的理解来为未来的研究服务。最重要的是，这项研究将为未来开发和测试高效且有效的多层次干预措施提供信息，以连接患者、提供者和卫生系统，以优化质量计划和以患者为中心的护理。