PRIS-M: Precision Monitoring to Transform Care

PRIS-M:精准监测以改变护理方式

基本信息

  • 批准号:
    10308563
  • 负责人:
  • 金额:
    --
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2015
  • 资助国家:
    美国
  • 起止时间:
    2015-10-01 至 2020-09-30
  • 项目状态:
    已结题

项目摘要

 DESCRIPTION (provided by applicant): Background and Specific Aims The VHA is unquestionably a leader in use of electronic health record (EHR) data to inform clinical, operational, and administrative decisions. Despite the growing granularity and accessibility of these data, however, data are currently most commonly used to retrospectively evaluate quality of care rather than to provide the right data at the right time to the right person in a way that increases patient and staff satisfaction and improves healthcare outcomes. The Precision Monitoring (PRIS-M) to Transform Care program meets this critical need as it aims to: 1) Implement and evaluate electronic clinical quality measures (eCQMs) and decision support tools at the point of care; 2) Conduct scalable clinical quality improvement projects that link electronic data to provider actions and reporting; 3) Investigate the effects of providing actionable EHR-based data on care team and Veteran behaviors and satisfaction; and 4) Identify the implementation strategies and contextual factors that activate VHA providers, leaders, and Veterans to use data to transform care. Methods With the ongoing input of our core partners, these aims will be accomplished via core research and quality improvement projects that cover multiple conditions and care settings. Our projects focus on: 1) national implementation of inpatient eCQMs, 2) testing telehealth modules and eCQMs for improving rapid transient ischemic attack (TIA) care, 3) decision support to deimplement inappropriate carotid ultrasound image ordering, and 4) a local quality improvement project to implement and evaluate a remote sleep apnea monitoring program. In addition, the PRIS-M program includes two additional projects: one to implement and evaluate the first Emergency Department Clinical Pathway decision support tool (acute stroke care) being rolled out to facilities in January 2016, and one to implement a local program of electronic documentation and display of patient behavior change goals to improve coordination and satisfaction with care. These projects are supported by an Implementation and Data Core that works across all projects to facilitate efficient use of data; usability testing of new tools; and standardized use f implementation measures, methods, and analytic approaches. Our overarching implementation strategy focuses on activating individuals and groups to use data to transform care, and we use the CFIR framework to plan data collection and analyses across projects to identify core implementation strategies and contextual factors that impact how people use data to transform care. Key partners include OIA/OABI, the Office of Specialty Care, the National Center for Health Promotion and Disease Prevention, the Office of Telehealth, the Roudebush VAMC, and the VA Center for Applied Systems Engineering. Anticipated impacts The PRIS-M Program directly addresses the Blueprint for Excellence Strategy Three: Leverage information technologies, analytics, and models of healthcare delivery to optimize individual and population health outcomes. Our projects lead directly to the implementation and evaluation of tools that will be useful across all VHA facilities and multiple clinical conditions and settings. We also wil address the important implementation questions about how best to use data to activate providers, healthcare teams, and Veterans to improve healthcare delivery and outcomes. In total, this program will provide multiple new proven tools and strategies for VHA to use as it leads the nation in leveraging its data systems to transform care.
 描述(由申请人提供): VHA无疑是使用电子健康记录(EHR)数据为临床、运营和管理决策提供信息的领导者。尽管这些数据的粒度和可访问性越来越大,但是,数据目前最常用于回顾性评估护理质量,而不是在正确的位置提供正确的数据。 以提高患者和工作人员满意度并改善医疗保健结果的方式将时间交给合适的人。精准监测(PRIS-M)转变护理计划满足了这一关键需求,因为它旨在:1)在护理点实施和评估电子临床质量措施(eCQM)和决策支持工具; 2)实施可扩展的临床质量改进项目,将电子数据与提供者的行动和报告联系起来; 3)调查提供可操作的基于EHR的数据对护理团队和退伍军人行为和满意度的影响;以及4)确定激活VHA提供者、领导者和退伍军人使用数据来转变护理的实施策略和背景因素。随着我们的核心合作伙伴的持续投入,这些目标将通过核心研究和质量改进项目,涵盖多种条件和护理环境来实现。我们的项目集中于:1)全国实施住院eCQM,2)测试远程医疗模块和eCQM,以改善快速短暂性脑缺血发作(TIA)护理,3)决策支持,以取消不适当的颈动脉超声图像排序,以及4)本地质量改进项目,以实施和评估远程睡眠呼吸暂停监测计划。此外,PRIS-M计划还包括两个额外的项目:一个是实施和评估第一个急诊科临床路径决策支持工具(急性卒中护理),该工具将于2016年1月在各机构推出,另一个是实施一个本地电子文档计划,并显示患者行为改变目标,以改善护理协调和满意度。这些项目得到了一个实施和数据核心的支持,该核心适用于所有项目,以促进数据的有效使用;新工具的可用性测试;以及实施措施,方法和分析方法的标准化使用。我们的总体实施策略侧重于激活个人和团体使用数据来改变护理,我们使用CFIR框架来规划跨项目的数据收集和分析,以确定影响人们如何使用数据来改变护理的核心实施策略和背景因素。主要合作伙伴包括OIA/OABI、专科护理办公室、国家健康促进和疾病预防中心、远程保健办公室、Roudebush VAMC和VA应用系统工程中心。PRIS-M计划直接针对卓越战略三的蓝图:利用信息技术、分析和医疗保健提供模型来优化个人和人群的健康结果。我们的项目直接导致工具的实施和评估,这些工具将适用于所有VHA设施和多种临床条件和设置。我们还将解决重要的实施问题,即如何最好地使用数据来激活提供者、医疗团队和退伍军人,以改善医疗服务和结果。总的来说,该计划将为VHA提供多种新的经过验证的工具和策略,因为它在利用其数据系统来改变护理方面领先全国。

项目成果

期刊论文数量(11)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators.
一项整群随机质量改进研究,旨在改善两项住院患者中风质量指标。
  • DOI:
    10.1136/bmjqs-2015-004188
  • 发表时间:
    2016
  • 期刊:
  • 影响因子:
    5.4
  • 作者:
    Williams,Linda;Daggett,Virginia;Slaven,JamesE;Yu,Zhangsheng;Sager,Danielle;Myers,Jennifer;Plue,Laurie;Woodward-Hagg,Heather;Damush,TeresaM
  • 通讯作者:
    Damush,TeresaM
Hospital Factors, Performance on Process Measures After Transient Ischemic Attack, and 90-Day Ischemic Stroke Incidence.
  • DOI:
    10.1161/strokeaha.120.031721
  • 发表时间:
    2021-07
  • 期刊:
  • 影响因子:
    8.3
  • 作者:
    Levine DA;Perkins AJ;Sico JJ;Myers LJ;Phipps MS;Zhang Y;Bravata DM
  • 通讯作者:
    Bravata DM
Active and receptive arts participation and their association with mortality among adults in the United States: a longitudinal cohort study.
积极和接受的艺术参与及其与美国成年人死亡率的关系:一项纵向队列研究。
  • DOI:
    10.1016/j.puhe.2021.05.034
  • 发表时间:
    2021
  • 期刊:
  • 影响因子:
    5.2
  • 作者:
    Story,KristinM;Yang,Ziyi;Bravata,DawnM
  • 通讯作者:
    Bravata,DawnM
Trends in Preventative Health Services for Veterans with Military Coverage Compared to Non-Military Coverage.
与非军事保险相比,军事保险退伍军人预防性医疗服务的趋势。
  • DOI:
    10.1007/s11606-019-05377-w
  • 发表时间:
    2020
  • 期刊:
  • 影响因子:
    5.7
  • 作者:
    Tummalapalli,SriLekha;Keyhani,Salomeh
  • 通讯作者:
    Keyhani,Salomeh
Factors Associated With Hospitalization and Death After COVID-19 Diagnosis Among Patients With Rheumatic Disease: An Analysis of Veterans Affairs Data.
  • DOI:
    10.1002/acr2.11328
  • 发表时间:
    2021-11
  • 期刊:
  • 影响因子:
    3.4
  • 作者:
    Schmajuk G;Montgomery AD;Leonard S;Li J;Gianfrancesco M;Seet A;Izadi Z;Yazdany J;Keyhani S
  • 通讯作者:
    Keyhani S
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Dawn Marie Bravata其他文献

Dawn Marie Bravata的其他文献

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{{ truncateString('Dawn Marie Bravata', 18)}}的其他基金

Addressing Sleep Apnea Post-Stroke (ASAP)
解决中风后睡眠呼吸暂停问题(尽快)
  • 批准号:
    10607990
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
Addressing Sleep Apnea Post-Stroke (ASAP)
解决中风后睡眠呼吸暂停问题(尽快)
  • 批准号:
    9716768
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
Addressing Sleep Apnea Post-Stroke (ASAP)
解决中风后睡眠呼吸暂停问题(尽快)
  • 批准号:
    10152370
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
Addressing Sleep Apnea Post-Stroke (ASAP)
解决中风后睡眠呼吸暂停问题(尽快)
  • 批准号:
    10395931
  • 财政年份:
    2020
  • 资助金额:
    --
  • 项目类别:
PRIS-M: Precision Monitoring to Transform Care
PRIS-M:精准监测以改变护理方式
  • 批准号:
    10181043
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
PRIS-M: Precision Monitoring to Transform Care
PRIS-M:精准监测以改变护理方式
  • 批准号:
    9076717
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
PRIS-M: Precision Monitoring to Transform Care
PRIS-M:精准监测以改变护理方式
  • 批准号:
    10179485
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
PRIS-M: Precision Monitoring to Transform Care
PRIS-M:精准监测以改变护理方式
  • 批准号:
    10021441
  • 财政年份:
    2015
  • 资助金额:
    --
  • 项目类别:
Sleep Apnea in TIA: Reducing Cardiovascular Risk with Positive Airway Pressure
TIA 中的睡眠呼吸暂停:通过气道正压通气降低心血管风险
  • 批准号:
    8015911
  • 财政年份:
    2010
  • 资助金额:
    --
  • 项目类别:
Sleep Apnea in TIA: Reducing Cardiovascular Risk with Positive Airway Pressure
TIA 中的睡眠呼吸暂停:通过气道正压通气降低心血管风险
  • 批准号:
    8145211
  • 财政年份:
    2010
  • 资助金额:
    --
  • 项目类别:

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