Improving the Quality of Care in Nursing Homes

提高疗养院的护理质量

基本信息

批准号：
7558993
负责人：
JOHN N. MORRIS
金额：
$ 53.04万
依托单位：
HEBREW REHABILITATION CENTER FOR AGED
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-04-05 至 2011-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7558993
关键词：
Address Administrator Affect Area Beds Bladder Control Caring Clinical Collaborations Communication Consent Control Groups Data Data Quality Data Set Discipline of Nursing Effectiveness Effectiveness of Interventions Eligibility Determination Ensure Evaluation Facility Controls Frail Elderly Frail Older Adults Intervention Joints Link Long-Term Care Massachusetts Measures Modeling Monitor National Institute on Aging Nursing Homes Outcome Pain Pain Measurement Participant Performance Physical Function Process Program Effectiveness Protocols documentation Public Health Quality Indicator Quality of Care Quality of life Randomized Recruitment Activity Rehabilitation Centers Rehabilitation therapy Relative (related person)Research Research Personnel Resources Role Sampling Site Staging System Training Training Programs Transference Treatment Efficacy Trust United States Centers for Medicare and Medicaid Services Upper arm Variant Work active method aged base clinical care cost depression design efficacy testing evidence base experience improved intervention program programs quality assurance response treatment as usual

项目摘要

This revised proposal is submitted in response to PA-02-162 "Long-Term Care Recipients: Quality of Life and Quality of Care Research" co-sponsored by the National Institute on Aging. With this proposal, the Hebrew Rehabilitation Center for Aged, in collaboration with the Massachusetts Department of Public Health, implement and evaluate the efficacy of an intervention to increase the number of high quality nursing homes in Massachusetts. The study involves mounting a three arm intervention in randomly selected nursing homes identified as performing in the aggregate at a poor or at best average level across multiple outcome domains. We call our program "SAVE" - standing for Sustaining Achievable Vitality and Effectiveness. The SAVE program brings together two approaches to care, one utilizing an organizational continuous quality improvement (CQI) system that includes problem recognition, evidence-based care, and evaluation; and the second the implementation of^ecific care protocols targeted at specific outcome areas. The three arms of our intervention include a control group delivering usual care, and two active treatment arms, one implementing the CQI programming (SAVE-CQI), the second implementing the CQI program and the specific protocol programming (SAVE-CQI+). We will sample from Massachusetts nursing homes and accrue to the study 40 that demonstrate adequate data quality but at, in least some of 12 clinical care areas, but have sub-optimal outcomes in these areas. Twenty-four will be assigned randomly to one of the active treatment arms, and 16 to the usual care control condition. We will use MDS data for facility residents of record over a 15-month period to measure changes in presumed quality of care using twelve of the Centers for Medicare and Medicaid Services quality indicators. PUBLIC HEALTH IMPORTANCE: This is an ambitious project, however, the importance of the research is amplified in this era of shrinking public resources and demographic changes resulting increasing numbers of frail, older adults requiring residential long-term care. The intervention itself is relatively low cost, as it will be designed for implementation by a facility's existing staff, and could be implemented in a larger number of facilities using extant resources if the evaluation is favorable.

该修订的提案是针对PA-02-162的“长期护理接收者：生活质量和护理研究质量“由美国国家老化研究所共同发起的。希伯来语老年康复中心与马萨诸塞州公共卫生部合作实施和评估干预措施增加高质量疗养院数量的功效在马萨诸塞州。该研究涉及在随机选择的疗养院中安装三臂干预确定为在多个结果中以较差或平均水平最多平均水平的总体表现域。我们称我们的计划为“保存” - 代表维持可实现的活力和有效性。这 Save计划汇集了两种护理方法，一种利用组织连续质量改进（CQI）系统，包括问题识别，基于证据的护理和评估；和其次，针对特定结果领域的^ECIFIC护理方案的实施。三臂的三臂我们的干预措施包括一个提供常规护理的对照组和两个主动治疗臂，一个实施CQI编程（Save-CQI），第二个实施CQI程序和特定协议编程（Save-CQI+）。我们将从马萨诸塞州的疗养院采样并积累在研究40的研究中证明了足够的数据质量，但至少在12个临床护理领域中的一些在这些领域具有次优最佳结果。二十四个将被随机分配给一个活动之一治疗臂，16处于通常的护理控制状态。我们将使用MDS数据进行设施的居民在15个月的时间内记录记录，以衡量使用十二个中心的假定护理质量变化用于医疗保险和医疗补助服务质量指标。公共卫生重要性：这是然而，雄心勃勃的项目在这个缩小公众的时代已经扩大了研究的重要性资源和人口变化，导致越来越多的脆弱的老年人需要住宅长期护理。干预本身的成本相对较低，因为它将设计用于实施设施的现有员工，如果是评估是有利的。