Health Care Providers and the Public Reporting of Nursing Home Quality in the United States Department of Veterans Affairs: Protocol for a Mixed Methods Pilot Study.
Health Care Providers and the Public Reporting of Nursing Home Quality in the United States Department of Veterans Affairs: Protocol for a Mixed Methods Pilot Study.
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DOI：
10.2196/23516
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发表时间：
2021-07-21
影响因子：
1.7
通讯作者：
Hartmann CW
中科院分区：
文献类型：
--
作者：
Pimentel CB;Clark V;Baughman AW;Berlowitz DR;Davila H;Mills WL;Mohr DC;Sullivan JL;Hartmann CW
2018年6月，美国退伍军人事务部（VA）开始公开报告其134个社区生活中心（CLC）的整体质量，使用基于CLC比较中捕获的国家质量措施数据的5-星星评级系统。鉴于私营部门在成绩单方面的积极经验，这是激励社区学习中心实现可衡量的质量改进的一个开创性时刻。然而，CLC比较数据的公开报告对CLC产生了重大和直接的影响。例如，报告卡便于比较社区护理中心和社区护理中心的情况，社区护理中心的情况通常更差。这可能会导致工作人员焦虑和潜在的意想不到的后果。此外，CLC比较旨在刺激改进，但报告卡的激励方面是未知的。了解工作人员的态度和早期反应是建设公共报告能力以提高质量的关键第一步。 我们将调整现有的社区养老院公众报告调查，以揭示重要的杠杆点，并支持社区护理中心的质量改进工作。我们的工作将以战略方向的概念框架为基础。我们有两个目标。首先，我们将定性研究CLC员工对CLC比较的反应。第二，我们将调整和扩大现有的社区养老院调查，以获得广泛的反应，然后试点适应调查中CLC。我们会与3间CLC（1间1-星星CLC、1间3-星星CLC及1间5-星星CLC）的员工进行面谈，以确定员工就其CLC的公开数据所采取的行动;员工对使用CLC Compare的承诺或困难;以及激励员工提高CLC质量的因素。我们将把这些发现与我们的概念框架，以适应和扩大社区养老院的调查，以目前的CLC环境。我们会与1CLC的员工进行认知访谈，以完善调查项目。然后，我们将在6个CLC（2个1-星星CLC，2个3-星星CLC和2个5-星星CLC）中进行试点调查，以评估调查的可行性，可接受性和初步的心理测量学特性。 我们将开发一个简短的调查，用于未来的国家行政部门，以确定全系统对CLC比较的反应;评估CLC比较对退伍军人临床结果和满意度的影响;并开发，测试和传播干预措施，以支持有意义的使用CLC比较质量改进。 从这项试点研究和未来的工作中获得的知识将有助于VA完善CLC Compare的使用方式，确保CLC工作人员理解并有动力使用其质量数据，并采取具体行动提高临床质量。这项试点研究的产品也将促进对其他关键VA临床领域的公开报告的影响的研究。DERR1-10.2196/23516
In June 2018, the United States Department of Veterans Affairs (VA) began the public reporting of its 134 Community Living Centers’ (CLCs) overall quality by using a 5-star rating system based on data from the national quality measures captured in CLC Compare. Given the private sector’s positive experience with report cards, this is a seminal moment for stimulating measurable quality improvements in CLCs. However, the public reporting of CLC Compare data raises substantial and immediate implications for CLCs. The report cards, for example, facilitate comparisons between CLCs and community nursing homes in which CLCs generally fare worse. This may lead to staff anxiety and potentially unintended consequences. Additionally, CLC Compare is designed to spur improvement, yet the motivating aspects of the report cards are unknown. Understanding staff attitudes and early responses is a critical first step in building the capacity for public reporting to spur quality. We will adapt an existing community nursing home public reporting survey to reveal important leverage points and support CLCs’ quality improvement efforts. Our work will be grounded in a conceptual framework of strategic orientation. We have 2 aims. First, we will qualitatively examine CLC staff reactions to CLC Compare. Second, we will adapt and expand upon an extant community nursing home survey to capture a broad range of responses and then pilot the adapted survey in CLCs. We will conduct interviews with staff at 3 CLCs (1 1-star CLC, 1 3-star CLC, and 1 5-star CLC) to identify staff actions taken in response to their CLCs’ public data; staff’s commitment to or difficulties with using CLC Compare; and factors that motivate staff to improve CLC quality. We will integrate these findings with our conceptual framework to adapt and expand a community nursing home survey to the current CLC environment. We will conduct cognitive interviews with staff in 1 CLC to refine survey items. We will then pilot the survey in 6 CLCs (2 1-star CLCs, 2 3-star CLCs, and 2 5-star CLCs) to assess the survey’s feasibility, acceptability, and preliminary psychometric properties. We will develop a brief survey for use in a future national administration to identify system-wide responses to CLC Compare; evaluate the impact of CLC Compare on veterans’ clinical outcomes and satisfaction; and develop, test, and disseminate interventions to support the meaningful use of CLC Compare for quality improvement. The knowledge gained from this pilot study and from future work will help VA refine how CLC Compare is used, ensure that CLC staff understand and are motivated to use its quality data, and implement concrete actions to improve clinical quality. The products from this pilot study will also facilitate studies on the effects of public reporting in other critical VA clinical areas. DERR1-10.2196/23516
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DOI：
10.1016/j.jamda.2019.01.139
发表时间：
2019-07-01
影响因子：
7.6
作者：
Mills, Whitney L.;Pimentel, Camilla B.;Hartmann, Christine W.
通讯作者：
Hartmann, Christine W.
DOI：
10.1111/j.1532-5415.2005.53207.x
发表时间：
2005-04-01
影响因子：
6.3
作者：
Berlowitz, DR;Rosen, AK;Mukamel, DB
通讯作者：
Mukamel, DB
影响因子：
5.7
作者：
Miller, Edward Alan;Gidmark, Stefanie;Intrator, Orna
通讯作者：
Intrator, Orna
DOI：
10.2307/257544
发表时间：
1978-07-01
期刊：
Academy of management review. Academy of Management
影响因子：
--
作者：
Miles, R E;Snow, C C;Coleman, H J Jr
通讯作者：
Coleman, H J Jr
影响因子：
5.7
作者：
Hartmann, Christine W.;Mills, Whitney L.;Snow, Andrea Lynn
通讯作者：
Snow, Andrea Lynn