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: 10308438
• 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 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10308438
• 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.

家庭卓越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的能力， 综合的，退伍军人和退伍军人合作的，数据驱动的方法，以非机构护理， 弗吉尼亚退伍军人事务部照顾各种残疾和年龄的退伍军人，他们的照顾需要 照顾者的参与以及家庭和社区服务的使用。然而，关于哪些信息， 退伍军人最有可能受益于缺乏哪种类型的护理，目前的治疗提供系统也是如此 通常无法满足退伍军人和护理人员的需求，由于当地设施的限制， 资源缺乏或不匹配，以及执行、评估和传播最佳做法的综合系统 通过退伍军人事务部业务办事处的做法尚未得到充分发展。 使用慢性病护理模式的适应作为我们的理论框架，我们提出了一套目标， 使VA能够提供最适当和有效的非机构护理匹配每个退伍军人的 需要和情况。我们的工作支持知识的快速生产，使用共享的指标， 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、退伍军人管理人员、 和非VA提供者，以及在做出有关护理服务和计划的知情选择方面的领导力 规划我们的具体目标如下： 目标1：试行创新干预措施，改善四个社区的非机构护理 参与本提案的VAMC，使用混合实施/有效性方法评估 可行性和影响。我们的试点将由每个站点与创新核心合作进行， 重点是退伍军人和护理人员之间的协调，以及VA和非VA护理之间的协调。 目标2：开发和验证由企业负责人驱动的成果和绩效指标， 评估家庭和社区为基础的护理计划和整个VA交付。这一目标将由 成果和实施（O&I）核心。 目标3：为不同的非住院护理提供要素确定最佳集群 退伍军人群体。数据和政策（D&P）核心将监督建模工作，以确定 为不同人群提供有效的非机构护理。 目标4：整合这些目标的结果和可交付成果，开发一个工具包， 用于改善非机构护理。工具包的组成部分将包括培训课程 和提供家庭和社区护理方面的最佳做法，这是一套由利益攸关方驱动的成果， 性能指标、本地站点需求和就绪性评估工具，以及 具体方案和方案类型的实施，并将通过以下方式打包供VA范围内传播： O&I核心 我们的跨四个VAMC的临床医生和卫生服务研究人员的多学科团队将在 串联，以确保英雄关怀卓越中心作为一个模型，为卓越的培训， 创新，评估，实施和传播VA非机构护理的最佳做法， 超越。由此产生的工作将使一个周期的改善，这是至关重要的VA转型为 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。