Organizational Factors and the Delivery of Nursing Home Care

组织因素和疗养院护理的提供

• 批准号: 8893850
• 负责人: David George Stevenson
• 金额: $ 11.59万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-15 至 2016-04-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8893850
• 关键词: Accounting; Acute; Address; Aging; Area; Award; Caring; Case Study; Characteristics; Clinical; Collaborations; Communities; Complex; Data; Data Set; Development; Dimensions; Discipline of Nursing; Doctor of Philosophy; Ethics; Future; Goals; Health Policy; Heterogeneity; Home Nursing Care; Home environment; Hospice Care; Industry; K-Series Research Career Programs; Knowledge; Long-Term Care; Marketing; Medicaid; Medicare; Mentored Research Scientist Development Award; Mentors; Methods; National Institute on Aging; Nature; Nursing Homes; Outcome; Ownership; Palliative Care; Pattern; Philosophy; Play; Policies; Population; Provider; Quality of Care; Rehabilitation therapy; Relative (related person); Research; Research Methodology; Research Personnel; Research Support; Research Training; Role; Scientist; Services; Shapes; Skilled Nursing Facilities; Standardization; Structure; Surveys; Time; Training; Training Activity; Training Support; Typology; United States; Variant; Work; base; care delivery; career development; clinical care; clinical practice; end of life; health care service organization; hospice environment; improved; insight; interest; knowledge base; lens; medical schools; meetings; member; nursing home length of stay; payment; professor; skills; social; theories; trait; Accounting; Acute; Address; Aging; Area; Award; Caring; Case Study; Characteristics; Clinical; Collaborations; Communities; Complex; Data; Data Set; Development; Dimensions; Discipline of Nursing; Doctor of Philosophy; Ethics; Future; Goals; Health Policy; Heterogeneity; Home Nursing Care; Home environment; Hospice Care; Industry; K-Series Research Career Programs; Knowledge; Long-Term Care; Marketing; Medicaid; Medicare; Mentored Research Scientist Development Award; Mentors; Methods; National Institute on Aging; Nature; Nursing Homes; Outcome; Ownership; Palliative Care; Pattern; Philosophy; Play; Policies; Population; Provider; Quality of Care; Rehabilitation therapy; Relative (related person); Research; Research Methodology; Research Personnel; Research Support; Research Training; Role; Scientist; Services; Shapes; Skilled Nursing Facilities; Standardization; Structure; Surveys; Time; Training; Training Activity; Training Support; Typology; United States; Variant; Work; base; care delivery; career development; clinical care; clinical practice; end of life; health care service organization; hospice environment; improved; insight; interest; knowledge base; lens; medical schools; meetings; member; nursing home length of stay; payment; professor; skills; social; theories; trait

DESCRIPTION (provided by applicant): David G. Stevenson, PhD. is an Associate Professor in the Department of Health Care Policy at Harvard Medical School with interdisciplinary training in ethics and health policy and a strong commitment to research in aging and long-term care. His previous work has focused on a broad range of topics in long-term care, including long-term-care financing options for the future, the influence of corporate structure on nursing home care, and the rising use of hospice care among nursing home residents. In the attached resubmission, Dr. Stevenson seeks training and research support through the National Institute on Aging Mentored Research Scientist Development Award (K01) mechanism. In collaboration with his mentors for this award - Drs. Michael Chernew (primary), Rob Huckman, Susan Mitchell, and David Grabowski - Dr. Stevenson has developed a training and research plan to address important gaps in his current knowledge base and to pursue newly- focused research. In particular, the broad goal of his K01 proposal is to gain the theoretical and methodological skills needed to become a national leader on how organizational factors influence the delivery of nursing home care and, importantly, to investigate how these insights might be used to assure, improve, and achieve high quality care. Specific to those goals, in the course of the K01 award, he will obtain further training in organizational analysis and management principles of health care organizations and in more applied dimensions such as the organization and delivery of care in the nursing home, particularly for residents at the end of life. The career development activities consist of a strategy and management component supervised by Dr. Huckman, a clinical and end of life component supervised by Dr. Mitchell, and an overarching data and methods component supervised by Drs. Chernew and Grabowski. As detailed in the proposal, Dr. Stevenson would address some of his deficits in knowledge in the context of formal coursework (e.g., coursework in organizational theory and related research methods) and would address others in the context of more informal, practically-oriented activities (e.g., observing care planning activities at a local nursing home and participating in palliative care grand rounds). The career development award includes a research plan that will enable Dr. Stevenson to apply the knowledge gained in the training activities. As outlined in the proposal, he will rely on a mixed-methods approach to pursue studies in three areas that have particular relevance for the role of organizational factors in shaping nursing home care in the United States: i) the scope and relevance of nursing home chain ownership in the United States; ii) the delivery of hospice care in nursing homes; and iii) the growing role of post-acute care in nursing homes. Research aims included in the first, generally-focused area are largely descriptive and will inform research into the other, more applied topics.

描述（由申请人提供）：David G. Stevenson博士。是哈佛医学院卫生保健政策系的副教授，对伦理和卫生政策的跨学科培训以及对衰老和长期护理研究的坚定承诺。他以前的工作集中在长期护理中的广泛主题上，包括未来的长期护理融资选择，公司结构对疗养院护理的影响以及在疗养院居民中使用临终关怀的不断增加。在随附的重新提交中，史蒂文森博士通过美国国家老化研究所的研究科学家发展奖（K01）机制寻求培训和研究支持。与他的导师合作获得该奖项-Drs。迈克尔·切尔纳（Michael Chernew）（主要），罗布·哈克曼（Rob Huckman），苏珊·米切尔（Susan Mitchell）和大卫·格拉布洛夫斯基（David Grabowski） - 史蒂文森（Stevenson）博士制定了一项培训和研究计划，以解决他当前知识库中的重要差距，并从事新的专注研究。特别是，他的K01提案的广泛目标是获得成为国家领导者在组织因素如何影响疗养院护理的交付中所需的理论和方法学技能，并且重要的是要研究如何使用这些见解来确保，改善和实现高质量护理。在K01奖的过程中，他将在卫生保健组织的组织分析和管理原则以及更应用的维度（例如疗养院的组织和提供护理服务）中，特别是对于生命末期的居民，在组织分析和管理方面的进一步培训。职业发展活动由Huckman博士监督的战略和管理组成，该战略和管理部门由Mitchell博士监督的临床和终止终止组成，以及由Drs监督的总体数据和方法组成部分。切尔恩和格拉布斯基。如该提案中所述，史蒂文森博士将在正式课程工作（例如，组织理论和相关研究方法的课程工作）中解决他在知识方面的一些缺陷，并将在更非正式的，实际上是面向实践的活动的背景下（例如，在地方护理家庭中观察护理计划活动和参与Palliatiative Care grand Foursss）对他人的讨论。职业发展奖包括一项研究计划，该计划将使史蒂文森博士能够应用培训活动中获得的知识。如该提案中概述的那样，他将依靠一种混合方法的方法来在三个领域进行研究，这些领域与组织因素在塑造美国的疗养院护理中的作用特别相关：i）i）美国养老院链的范围和相关性； ii）在疗养院提供临终关怀； iii）急性护理在疗养院中的作用日益增长。第一个，集中的领域中包括的研究目的在很大程度上具有描述性，并将为其他更应用的主题提供研究。