Novel IT to Create Patient-Integrated Quality Improvement

创新 IT 创造患者综合质量改进

• 批准号: 9357524
• 负责人: Naomi Shula Bardach
• 金额: $ 13.19万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2018-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9357524
• 关键词: Novel; Create; Patient; Integrated; Quality

Abstract More than a decade after the seminal IOM report, “To Err is Human”, failure rates in patient safety remain stubbornly high in hospitals. Prior efforts to improve hospital quality have had relatively little impact, in part due to limited access to timely quality improvement data. Our long-term goal is to leverage existing technologies to give voice to hospitalized patients and their family members, leading to improvements in hospital safety and quality. The overall objective in this application is to create and evaluate a tool that gathers patient and family member feedback and makes it rapidly available to providers, enabling nimble and responsive safety and quality improvement efforts. The central hypothesis, based on the theory of co-production, is that observations from patients and families, gathered in a structured way, will provide actionable information regarding patient safety and quality. The rationale for doing this project is to test an innovative new approach to creating a rapidly available data stream to providers who are working on specific improvement efforts, and a mechanism for creating a quality improvement approach that is inherently patient-centered. We plan to test our central hypothesis and thereby accomplish the objective of this application by focusing on the following areas of research for Health IT: Use, Implementation, and Impact on Outcomes, under the study type “Pilot and feasibility”, pursuing three specific aims: Aim 1. Determine feasibility and acceptability of the patient data collection and provider dashboard tool (Use and Implementation). We will conduct usability testing prior to study start, measure user (patients and providers) engagement over time, and gather feedback about the tool at study end. We hypothesize that patient and caregiver characteristics will predict tool use. Aim 2. Assess whether reporting patient- and caregiver- observed processes of care to providers leads to changes over time (Implementation). We hypothesize that performance on structured items of interest will improve over time with rapidly available data presented to providers. Aim 3. Estimate tool implementation effect sizes, using a pre- post design, on medical errors (Impact on outcomes). The proposed research is innovative, in our opinion, based on a paradigm-shifting conceptual model of patient-engaged quality improvement, and because it leverages technology to gather and present data in an unprecedented manner. The expected contribution of the proposed research will be an adapted tool that will gather meaningful and important data on patient safety and present it in an actionable way to providers and hospital leaders, resulting in a powerful data stream to fuel rapid improvements in patient safety. Pilot data from this proposal will inform the design of a future cluster- randomized trial of the new tool across multiple hospital systems. This contribution will be significant because it represents key steps towards a new approach to improving patient safety in the hospital.

抽象的 在 IOM 发表开创性报告《人皆会犯错》十多年后，患者安全方面的失败率仍然存在 医院此前为提高医院质量所做的努力收效相对较小，部分原因是这样。 限制对及时质量改进数据的访问。我们的长期目标是利用现有技术来实现。 为住院患者及其家属提供发言权，从而改善医院安全和 该应用程序的总体目标是创建和评估一个收集患者和家属的工具。 会员反馈并将其快速提供给提供商，从而实现灵活且响应迅速的安全和 基于共同生产理论的中心假设是观察结果。 以结构化方式收集的患者和家属的信息将提供有关患者的可操作信息 开展该项目的目的是测试一种创新的方法来创建一个安全和质量。 向致力于具体改进工作的提供商提供快速可用的数据流，以及一种机制 我们计划测试我们的中心，以创建一种本质上以患者为中心的质量改进方法。 假设，从而通过关注以下领域来实现本应用的目标 健康信息技术研究：使用、实施以及对结果的影响，研究类型为“试点和 可行性”，追求三个具体目标： 目标 1. 确定患者数据的可行性和可接受性 收集和提供者仪表板工具（使用和实施）我们将在之前进行可用性测试。 研究开始，衡量用户（患者和提供者）随时间的参与度，并收集有关该工具的反馈 在研究结束时，我们追求患者和护理人员的特征可以预测工具的使用。 向提供者报告患者和护理人员观察到的护理过程是否会随着时间的推移而发生变化 （实施）。随着时间的推移，感兴趣的结构化项目的性能将会提高。 目标 3. 使用预估计工具估算工具实施效果大小 我们认为，拟议的研究具有创新性，关于医疗错误（对结果的影响）。 基于患者参与的质量改进的范式转换概念模型，并且因为它 利用技术以前所未有的方式收集和呈现数据的预期贡献。 拟议的研究将是一个适应性工具，将收集有关患者安全的有意义且重要的数据 并以可行的方式向提供者和医院领导者展示，从而产生强大的数据流来推动 该提案的试点数据将为未来集群的设计提供信息。 在多个医院系统中对新工具进行随机试验这一贡献将是重大的，因为它。 代表了改善医院患者安全新方法的关键步骤。