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 在第二次IOM报告“ to Err是人类”的十多年后，患者安全的失败率仍然存在 顽固的医院高。提高医院质量的先前努力的影响相对较小，部分原因是 有限地访问及时的质量改进数据。我们的长期目标是利用现有技术来 向住院的患者及其家人发声，从而改善医院安全和 质量。此应用程序的总体目的是创建和评估一种收集患者和家人的工具 会员反馈，并使提供商迅速使用，使其能够灵活和响应安全性和 质量改进的工作。基于共同生产理论的中心假设是观察 以结构化的方式收集的患者和家庭将提供有关患者的可行信息 安全和质量。进行此项目的理由是测试一种创新的新方法来创建 向正在从事特定改进工作的提供商快速获得数据流以及一种机制 用于创建本质上以患者为中心的质量改进方法。我们计划测试中央 假设，从而通过关注以下领域来实现此应用的目标 健康研究：使用，实施和对结果的使用，根据研究类型“飞行员和 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 收集和提供商仪表板工具（使用和实现）。我们将在之前进行可用性测试 学习开始，随着时间的推移测量用户（患者和提供者）参与，并收集有关该工具的反馈 在研究端。我们假设患者和护理人员特征将预测工具的使用。目标2。评估 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变化 （执行）。我们假设在结构化项目上的性能会随着时间的流逝而提高 AIM 3。估算工具实施效应大小，使用预先 后设计，医疗错误（对结果的影响）。我们认为，拟议的研究是创新的 基于患者参与质量改进的范式转移概念模型，因为它 利用技术以前所未有的方式收集和呈现数据。预期的贡献 拟议的研究将是一种适应性的工具，将收集有关患者安全的有意义而重要的数据 并以可行的方式向提供者和医院领导者展示它，从而产生强大的数据流以加油 患者安全的快速改善。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的随机试验。这项贡献将是重要的，因为它 代表着一种新方法来改善医院的安全性的关键步骤。