Team Performance and Quality of Care in Nursing Homes

疗养院的团队绩效和护理质量

• 批准号: 7113173
• 负责人: HELENA TEMKIN-GREENER
• 金额: $ 28.64万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7113173
• 关键词: clinical research; communication; conflict; decubitus ulcer; functional ability; health care personnel performance; health care quality; health services research tag; health surveys; human data; human subject; interview; leadership; nursing homes; outcomes research; patient care; statistics /biometry; urinary incontinence

DESCRIPTION (provided by applicant): The objective of the proposed study is to assess the performance of nursing home teams and to investigate the impact of team performance on patient care outcomes. Studies in settings outside of nursing homes have shown the existence of a strong relationship between team performance and risk-adjusted patient outcomes. If this relationship can be documented in nursing homes, there is a significant potential for improving the quality of patient care through identification and dissemination of information about model team practices. The conceptual model for the analyses rests on the quality paradigm proposed by Donabedian and a cause-and-effect model adapted from Shorten. The study will include a randomly selected sample of 375 nursing homes throughout New York State, with an anticipated 60 percent participation rate. Quality of care will be assessed with respect to three outcomes - functional status, pressure ulcers, and urinary incontinence. Team performance will be measured on six dimensions - leadership, communication, coordination, conflict management, team cohesion, and team effectiveness. Primary data will be obtained through surveys and interviews. Secondary data will include the minimum data set (MDS), the On-line Survey Certification and Reporting System (OSCAR), and the Area Resource File (ARF). Data analyses will include multivariate regression techniques to test specific hypotheses about team performance and the association between team performance and other structural variables with respect to each outcome, controlling for individual risk factors present at admission to nursing home. The information to be gained from this study is particularly timely, as concerns about quality of care in nursing homes continue and as apprehension about the staffing and turnover of nursing home workforce intensify. To date, research into the relationship between quality of care and organizational or workforce factors has been largely anecdotal. Empirical insights gained from this study may be used to test and evaluate workplace innovations and public policy interventions aimed at improving workforce retention and quality, thus improving the quality of patient care.

描述（由申请人提供）：拟议研究的目的是评估养老院团队的绩效，并调查团队绩效对患者护理结果的影响。在疗养院以外的环境中进行的研究表明，团队绩效与风险调整后的患者结局之间存在密切关系。如果这种关系可以记录在疗养院，有一个显着的潜力，通过识别和传播信息的模式团队的做法，提高病人的护理质量。分析的概念模型依赖于Donabedian提出的质量范式和改编自Shorten的因果模型。这项研究将包括在纽约州随机选择的375家养老院的样本，预计参与率为60%。护理质量将根据三个结局进行评估-功能状态、压疮和尿失禁。团队绩效将从六个方面进行衡量：领导力、沟通、协调、冲突管理、团队凝聚力和团队效率。主要数据将通过调查和访谈获得。二级数据将包括最低数据集（MDS）、联机调查认证和报告系统（OSCAR）和地区资源档案（ARF）。数据分析将包括多元回归技术，以测试特定的假设团队绩效和团队绩效和其他结构变量之间的关联，就每个结果，控制个人的风险因素，目前在入院疗养院。从这项研究中获得的信息是特别及时的，因为人们对养老院护理质量的担忧仍在继续，而且对养老院劳动力的人员配置和流动率的担忧也在加剧。迄今为止，对护理质量与组织或劳动力因素之间关系的研究主要是轶事。从这项研究中获得的经验性见解可用于测试和评估旨在提高劳动力保留率的工作场所创新和公共政策干预， 质量，从而提高患者护理质量。