Home Excellence Research and Outcomes Center to Advance, Redefine and Evaluate Non-institutional Caregiving (HERO CARE)

卓越家庭研究和成果中心推进、重新定义和评估非机构护理 (HERO CARE)

• 批准号: 9947748
• 负责人: Stuti Dang
• 金额: --
• 依托单位: SOUTH TEXAS VETERANS HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-10-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9947748
• 关键词: Address; Age; Assessment tool; Caregiver support; Caregivers; Caring; Communities; Data; Educational Curriculum; Elements; Ensure; Evaluation; Feedback; Goals; Growth; Health Services; Healthcare Systems; Home; Individual; Intervention; Knowledge; Leadership; Learning; Modeling; Outcome; Performance; Policies; Population; Production; Provider; Readiness; Recommendation; Research; Research Personnel; Resources; Rural Community; Services; Shapes; Site; System; Training; Urban Community; Veterans; Voice; Work; care delivery; care systems; caregiving; chronic care model; community based care; community based service; disability; effectiveness implementation study; empowered; improved; innovation; meetings; military veteran; multidisciplinary; patient population; programs; service programs

The goal of the Home Excellence Resource Center to Advance, Redefine, and Evaluate Non- Institutional Care (HERO CARE) Center of Excellence is to expand the capacity of the VA to deliver integrated, Veteran- and caregiver-partnered, data-driven approaches to non-institutional care across VA. The VA cares for Veterans across a wide range of disabilities and ages whose care requires the involvement of caregivers and use of home- and community-based services. Yet information regarding which Veterans are most likely benefit from which types of care is lacking, current systems of treatment delivery too often fail to meet the needs of Veterans and caregivers, services available are often limited due to local facility resource lack or mismatch, and a comprehensive system for implementing, evaluating, and disseminating best practices through VA operational offices has not been fully developed. Using an adaptation of the chronic care model as our theoretical framework, we propose a set of aims that will enable the VA to provide the most appropriate and effective non-institutional care matched to each Veteran’s needs and circumstances. Our work supports the rapid production of knowledge, using shared metrics and data as a common platform for evaluation and feedback, with the goal of empowering Veterans, caregivers, VA and non-VA providers, and leadership in making informed choices regarding care services and program planning. Our specific aims are as follows: Aim 1: Pilot innovative interventions to improve non-institutional care at each of the four VAMCs involved in this proposal, using a hybrid implementation / effectiveness approach to evaluate feasibility and impact. Our pilots will be conducted by each site in partnership with the Innovation Core, focusing on coordination between Veterans and caregivers, as well as between VA and non-VA care. Aim 2: Develop and validate stakeholder-driven outcome and performance metrics to aid in evaluating home- and community-based care programs and delivery across VA. This aim will be led by the Outcomes and Implementation (O&I) Core. Aim 3: Determine the optimal clusters of non-institutional care delivery elements for different Veteran populations. The Data and Policy (D&P) Core will oversee modeling efforts to determine the most effective non-institutional care elements for different populations. Aim 4: Integrate findings and deliverables from across these aims to develop a toolkit that can be used across VA to improve non-institutional care. Toolkit components will include curricula for training and delivery of best practices in home- and community-based care, a stakeholder-driven set of outcome and performance metrics, a local site needs and readiness assessment tool, and recommendations for implementation of specific programs and program types, and will be packaged for VA-wide dissemination by the O&I Core. Our multi-disciplinary team of clinicians and health services researchers across four VAMCs will work in tandem to ensure the HERO CARE Center of Excellence serves as a model for excellence in training, innovation, evaluation, implementation and spread of best practices in non-institutional care across VA and beyond. The resulting work will enable a cycle of improvement that is vital to the VA transformation to a Learning Health Care System, and that will enable VA to meet the needs of Veterans and caregivers in the decades to come.

卓越家居资源中心的目标是推进、重新定义和评估非 机构护理 (HERO CARE) 卓越中心旨在扩大 VA 的交付能力 综合的、退伍军人和护理人员合作的、数据驱动的非机构护理方法 退伍军人管理局照顾各种残疾和年龄的退伍军人，他们的护理需要 护理人员的参与以及家庭和社区服务的使用尚无相关信息。 退伍军人最有可能从缺乏的护理类型以及当前的治疗提供系统中受益 通常无法满足退伍军人和护理人员的需求，由于当地设施的原因，可用的服务往往受到限制 资源缺乏或不匹配，以及实施、评估和传播最佳方案的综合系统 VA 运营办公室的实践尚未完全发展。 使用慢性护理模型的改编作为我们的理论框架，我们提出了一系列目标 使退伍军人管理局能够提供与每位退伍军人的情况相匹配的最适当、最有效的非机构护理 我们的工作使用共享的指标和环境来支持知识的快速生产。 数据作为评估和反馈的通用平台，目标是增强退伍军人、护理人员、退伍军人管理局的能力 和非 VA 提供者，以及在护理服务和计划方面做出明智选择的领导力 我们的具体目标如下： 目标 1：试点创新干预措施，以改善四个机构的非机构护理 参与本提案的 VAMC，使用混合实施/有效性方法来评估 我们的试点将由每个站点与创新核心合作进行， 重点关注退伍军人和护理人员之间以及 VA 和非 VA 护理之间的协调。 目标 2：开发并验证利益相关者驱动的成果和绩效指标，以帮助 评估整个 VA 的家庭和社区护理计划和实施情况。 结果和实施 (O&I) 核心。 目标 3：确定不同类型的非机构护理提供要素的最佳集群 退伍军人群体（D＆P）核心将监督建模工作以确定最重要的。 针对不同人群的有效的非机构护理要素。 目标 4：整合这些目标的发现和可交付成果，开发一个工具包，可以 整个 VA 用于改善非机构护理的工具包组件将包括培训课程。 提供家庭和社区护理的最佳实践、利益相关者驱动的一系列成果和 性能指标、本地站点需求和准备情况评估工具以及建议 实施特定计划和计划类型，并将打包在 VA 范围内传播 O&I 核心。 我们的多学科团队由来自四个 VAMC 的超级明星和卫生服务研究人员组成，他们将在 协同确保 HERO CARE 卓越中心成为卓越培训的典范， VA 和非机构护理最佳实践的创新、评估、实施和传播 由此产生的工作将实现一个改进周期，这对于 VA 转型为至关重要。 学习医疗保健系统，这将使 VA 能够满足退伍军人和护理人员的需求 未来几十年。