Person-centered quality measurement and management in a system for addictions treatment in New York State

纽约州成瘾治疗系统中以人为本的质量测量和管理

基本信息

批准号：
10772463
负责人：
Constance Burke
金额：
$ 241.89万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-30 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10772463
关键词：
Accountability Accounting Address Adoption Adverse event Ambulatory Care Facilities Automobile Driving Black Populations Caring Cessation of life Characteristics Client Clinic Clinical Collaborations Communities Consult Contracts Data Data Analyses Development Drug Metabolic Detoxication Drug user Effectiveness Electronic Health Record Elements Ensure Equity Event Evidence based practice Family Feedback Funding Goals Government Harm Reduction Health Healthcare Hospitalization Individual Insurance Carriers Intervention Interview Investments Latinx population Leadership Measurement Measures Mediation Medicaid Methods Monitor New York Opioid Outcome Overdose Patient-Focused Outcomes Patients Perception Performance Pharmaceutical Preparations Policies Process Professional counselor Property Psychometrics Qualitative Methods Quality of Care Questionnaires Recording of previous events Registries Reporting Research Resistance Risk Adjustment Science Services Statistical Methods Substance Use Disorder Surveys System Technology Testing Universities Validation Variant Vital Statistics Work addiction care systems data literacy effectiveness testing evidence base health inequalities improved medication for opioid use disorder mortality novel strategies opioid epidemic opioid use disorder overdose death person centered response social vulnerability substance use treatment synthetic opioid tool treatment center treatment services user centered design

项目摘要

Project Summary In 2021, the number of drug overdoses in New York continued to rise, with 4,946 deaths involving opioids. Synthetic opioids are driving the rise as these are mixed with other substances taken by people who use drugs (PWUD). Alarmingly, the rates of overdose deaths are rising faster for Black and Latinx individuals, exacerbating health inequities. The New York State agency that regulates addictions treatment—the Office of Addiction Services and Supports (OASAS)—oversees a system that annually serves 350,000 individuals with substance use disorders (SUD). Within the system, outpatient clinics provide the majority of treatment services for individuals with opioid use disorders (OUD). In response to the continuing opioid crisis, OASAS is calling for new approaches that embrace person-centered care, evidence-based practices, equitable treatment, and harm reduction principles. OASAS envisions a revised treatment system that better retains clients in treatment, mitigates adverse healthcare events, and reduces deaths. To drive change, OASAS will invest in a quality measurement and management (QM2) strategy that provides performance feedback to activate leadership and staff of clinics to improve practice as well as publicizes quality measures to ensure public accountability. Using the Donabedian framework as a guide, the OASAS QM2 strategy will include a suite of structural (e.g., client/counselor ratios), process (e.g., use of medications for OUD), and outcome (e.g., hospitalization for detoxification) quality measures. In support of the strategy, OASAS will also provide funding to ensure all clinics have electronic health records (EHR) that have capacity to capture and report on quality measures. The OASAS strategy will address common barriers to QM2 efforts, including: inadequate technological capacity at clinics, dearth of validated quality measures for SUD treatment, limited data literacy in the workforce, insufficient expertise in change management among staff, and clinic leadership resistance due to concerns about fairness in accounting for the clinical complexity of their clients. In addition, OASAS recognizes that gathering data directly from patients is essential to assessing whether their goals and needs are addressed in a person-centered system of care. OASAS will work with academic partners to develop measures and provide support to clinics to address these barriers. This QM2 research center (QM2-RC) proposal comes from an academic-government partnership that has a longstanding history of collaborating on studies to improve treatment for SUD. The broad aim is to build then test a science-based QM2 strategy for person-centered treatment. The project will leverage OASAS's investment in its new QM2 strategy and policy leadership. The academic partners will offer expertise in statistical methods for measurement validation, risk adjustment, and causal inference that will address some obstacles to QM2 as well as build the evidence base for the benefits of the strategy. The team will also assess how clinics and other stakeholders—e.g., patients, payers—incorporate the QM2 strategy into practice improvement, contract negotiations, and choosing clinics.

项目概要 2021年，纽约吸毒过量人数持续上升，有4,946人因阿片类药物死亡。合成阿片类药物正在推动这一增长，因为它们与吸毒者服用的其他物质混合在一起 (PWUD) 令人震惊的是，黑人和拉丁裔的吸毒过量死亡率上升得更快，加剧健康不平等的纽约州监管成瘾治疗的机构——办公室。成瘾服务和支持 (OASAS) — 监督每年为 350,000 人提供服务的系统在该系统内，门诊诊所提供大部分治疗服务。针对阿片类药物使用障碍 (OUD) 的个体为了应对持续的阿片类药物危机，OASAS 呼吁：拥抱以人为本的护理、循证实践、公平待遇和伤害的新方法 OASAS 设想了一个改进的治疗系统，可以更好地保留客户的治疗，减轻不良医疗事件并减少死亡为了推动变革，OASAS 将投资于质量。提供绩效反馈以激活领导力的测量和管理 (QM2) 策略和诊所工作人员改进实践并宣传质量措施以确保公共问责制。以 Donabedian 框架为指导，OASAS QM2 战略将包括一套结构（例如，客户/咨询师的比例）、过程（例如，使用 OUD 药物）和结果（例如，住院治疗）为支持该战略，OASAS 还将提供资金以确保所有这些措施。诊所拥有电子健康记录 (EHR)，能够捕获和报告质量指标。 OASAS 战略将解决 QM2 工作的常见障碍，包括：诊所、缺乏经过验证的 SUD 治疗质量措施、劳动力的数据素养有限、员工变革管理方面的专业知识不足，诊所领导层因担忧而抵制此外，OASAS 还认识到这一点。直接从患者那里收集数据对于评估他们的目标和需求是否得到满足至关重要 OASAS 将与学术伙伴合作制定措施并提供以人为本的护理系统。支持诊所解决这些障碍该 QM2 研究中心 (QM2-RC) 提案来自一个项目。学术与政府的伙伴关系有着悠久的合作研究历史，以改善 SUD 治疗的总体目标是建立并测试基于科学的以人为本的 QM2 策略。该项目将利用 OASAS 对其新 QM2 战略和政策领导力的投资。学术合作伙伴将提供统计方法方面的专业知识，用于测量验证、风险调整和因果推理将解决 QM2 的一些障碍，并为以下方面的好处建立证据基础该团队还将评估诊所和其他利益相关者（例如患者、付款人）如何整合。将 QM2 策略融入实践改进、合同谈判和选择诊所。