A Practice-based Intervention to Improve Care for a Diverse Population of Women with Urinary Incontinence

基于实践的干预措施,以改善对不同尿失禁女性群体的护理

基本信息

项目摘要

PROJECT ABSTRACT The burden of urinary incontinence (UI) on American women is immense in human and financial terms, and continues to rise with the growing population of older adults. The goal of this proposal is to improve the care for UI provided to women and, in doing so, decrease the utilization of specialty care while improving patient outcomes. Specific Aim 1 seeks to improve the quality of incontinence care provided to an ethnically diverse population of women through a controlled practice-based intervention involving primary care providers. The intervention involved the implementation of PCOR measures. Three Southern California medical groups will participate in a cluster randomized controlled trial in which 60 offices (20 per site) will be randomized to undergo a practice-based incontinence intervention led by a ”clinical champion dyad” comprised of a primary care provider and urologist/urogynecologist, both of whom are members of that specific medical group. The intervention will include physician education, individual performance feedback, electronic decision support, patient education using dedicated advanced practice providers (APPs), and the implementation of an electronic referral service. The quality of patient care, as evidenced by compliance with the quality indicators, will be measured across the two randomized arms after implementation of the intervention. The investigators for this proposal recently developed and pilot-tested a set of quality-of-care indicators (QIs) for urinary incontinence that encompass primary care for UI. Compliance with these quality indicators will be the key means to implement PCOR evidence, while, at the same time, measure quality. In addition, in Specific Aim 2, utilization of specialists will be compared before and after the intervention. The investigators hypothesize that improved care at the level of the primary care physician will reduce the number of specialty referrals. Lastly, Specific Aim 3 will seek to measure the effect of the intervention on patient outcomes. Under the hypothesis that a practice-based intervention will improve disease-specific outcomes, symptom severity, quality of life, and patient knowledge will be measured at baseline using validated questionnaires. After implementation of the intervention, these questionnaires will be given a second time six months later and outcomes will be compared between control and intervention groups. We expect that this intervention will also reduce disparities in care for underrepresented minorities.
项目摘要 尿失禁(UI)对美国妇女的负担是巨大的人力和财力, 随着老年人口的不断增长,该提案的目的是改善对 为女性提供UI,并在这样做的同时,减少了对专科护理的利用,同时改善了患者的 结果。具体目标1旨在提高为不同种族提供的失禁护理的质量, 通过涉及初级保健提供者的基于受控实践的干预措施,对妇女人口进行干预。的 干预措施涉及实施变革和组织振兴方案措施。三个南加州医疗组织将 参加一项随机分组对照试验,其中60个办公室(每个研究中心20个)将被随机分配接受 由初级保健提供者组成的“临床冠军二人组”领导的基于实践的失禁干预 和泌尿科医生/泌尿妇科医生,他们都是该特定医疗组的成员。干预将 包括医生教育、个人表现反馈、电子决策支持、患者教育 使用专门的高级实践提供者,并实施电子转介服务。 病人护理的质量,如符合质量指标所证明的,将在整个 干预实施后,两组随机分组。这项提案的调查人员最近 开发并试点测试了一套尿失禁护理质量指标(QIs),包括 初级保健UI遵守这些质量指标将是实施变革和组织振兴方案证据的关键手段, 与此同时,衡量质量。此外,在具体目标2中,将比较专家的利用情况 在干预前后。研究人员假设,改善初级保健水平, 护理医生将减少专科转诊的数量。最后,具体目标3将寻求衡量效果 of the intervention干预on patient病人outcomes结果.假设基于实践的干预会改善 将在基线时测量疾病特异性结局、症状严重程度、生活质量和患者知识 使用经过验证的问卷。在实施干预措施后,这些问卷将得到一个 六个月后进行第二次,并比较对照组和干预组的结果。我们 预计这种干预措施还将减少对代表性不足的少数群体的照顾方面的差异。

项目成果

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Jennifer Tash Anger其他文献

331: The Effect of Bulbar Urethroplasty on Erectile Function
  • DOI:
    10.1016/s0022-5347(18)34596-8
  • 发表时间:
    2005-04-01
  • 期刊:
  • 影响因子:
  • 作者:
    Jennifer Tash Anger;Neil D. Sherman;George D. Webster
  • 通讯作者:
    George D. Webster
1157: Minimally Invasive Sling with and Without Concomitant Pelvic Prolapse Surgery: Early Postoperative Outcomes
  • DOI:
    10.1016/s0022-5347(18)38394-0
  • 发表时间:
    2004-04-01
  • 期刊:
  • 影响因子:
  • 作者:
    Drew A. Dylewski;Jennifer Tash Anger;Cindy L. Amundsen;George D. Webster
  • 通讯作者:
    George D. Webster
238: Anastomotic Contracture and Incontinence after Radical Prostatectomy: A Graded Approach to Management
  • DOI:
    10.1016/s0022-5347(18)37500-1
  • 发表时间:
    2004-04-01
  • 期刊:
  • 影响因子:
  • 作者:
    Jennifer Tash Anger;Fernando C. Delvecchio;George D. Webster
  • 通讯作者:
    George D. Webster
66: A Proposal that Whenever Possible Stricture Excision be a Part of all Bulbar Urethroplasties: A Progressive Approach to Patient Selection
  • DOI:
    10.1016/s0022-5347(18)37328-2
  • 发表时间:
    2004-04-01
  • 期刊:
  • 影响因子:
  • 作者:
    Fernando C. Delvecchio;Jennifer Tash Anger;George D. Webster
  • 通讯作者:
    George D. Webster
493: Outcomes Following Erosions of the Artificial Urinary Sphincter
  • DOI:
    10.1016/s0022-5347(18)37755-3
  • 发表时间:
    2004-04-01
  • 期刊:
  • 影响因子:
  • 作者:
    Ganesh V. Raj;Andrew C. Peterson;Jennifer Tash Anger;George D. Webster
  • 通讯作者:
    George D. Webster

Jennifer Tash Anger的其他文献

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{{ truncateString('Jennifer Tash Anger', 18)}}的其他基金

The TRANS-SAFE Patient Safety Learning Lab: Systems Improvement for Psychosocial Safety in Transgender Care
TRANS-SAFE 患者安全学习实验室:跨性别护理中心理社会安全的系统改进
  • 批准号:
    10629073
  • 财政年份:
    2023
  • 资助金额:
    $ 97.75万
  • 项目类别:
A Practice-based Intervention to Improve Care for a Diverse Population of Women with Urinary Incontinence
基于实践的干预措施,以改善对不同尿失禁女性群体的护理
  • 批准号:
    10559509
  • 财政年份:
    2022
  • 资助金额:
    $ 97.75万
  • 项目类别:
KUH-ART: Advanced Research Training in Kidney disease, Urology and Hematology
KUH-ART:肾脏疾病、泌尿科和血液学高级研究培训
  • 批准号:
    10285905
  • 财政年份:
    2021
  • 资助金额:
    $ 97.75万
  • 项目类别:
Human Factors and Systems Integration in High Technology Surgery (HF-SIgHTS)
高技术手术中的人为因素和系统集成 (HF-SIgHTS)
  • 批准号:
    10221052
  • 财政年份:
    2018
  • 资助金额:
    $ 97.75万
  • 项目类别:
Human Factors and Systems Integration in High Technology Surgery (HF-SIgHTS)
高技术手术中的人为因素和系统集成 (HF-SIgHTS)
  • 批准号:
    10448248
  • 财政年份:
    2018
  • 资助金额:
    $ 97.75万
  • 项目类别:
Human Factors and Systems Integration in High Technology Surgery (HF-SIgHTS)
高技术手术中的人为因素和系统集成 (HF-SIgHTS)
  • 批准号:
    9982269
  • 财政年份:
    2018
  • 资助金额:
    $ 97.75万
  • 项目类别:
The Epidemiology of Interstitial Cystitis in a Nationwide Multiethnic VA Cohort
全国多民族 VA 队列中间质性膀胱炎的流行病学
  • 批准号:
    10220778
  • 财政年份:
    2015
  • 资助金额:
    $ 97.75万
  • 项目类别:
Microbiome and Proteome As Predictive Biomarkers of UCPPS
微生物组和蛋白质组作为 UCPPS 的预测生物标志物
  • 批准号:
    9532153
  • 财政年份:
    2014
  • 资助金额:
    $ 97.75万
  • 项目类别:
Microbiome and Proteome As Predictive Biomarkers of UCPPS
微生物组和蛋白质组作为 UCPPS 的预测生物标志物
  • 批准号:
    9113661
  • 财政年份:
    2014
  • 资助金额:
    $ 97.75万
  • 项目类别:
Improving the Delivery of Robotic Surgery
改善机器人手术的实施
  • 批准号:
    8825494
  • 财政年份:
    2014
  • 资助金额:
    $ 97.75万
  • 项目类别:

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基于实践的干预措施,以改善对不同尿失禁女性群体的护理
  • 批准号:
    10559509
  • 财政年份:
    2022
  • 资助金额:
    $ 97.75万
  • 项目类别:
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