Nursing Home IT: Optimal Medication and Care Delivery

简介(由申请人提供)：我们建议在七间疗养院实施健康资讯科技(HIT)系统，增加最佳实践决策支援模块，并评估对护理过程、居民健康结果、员工效率和满意度的影响。这项研究将： 1.领导合作伙伴关系，分析和重新设计临床工作流程，使用HIT将基于研究的最佳实践整合到日常工作中，以改进临床实践，并保持健康结果的可衡量改善。 2.实施和使用HIT，通过用户友好的技术，结合密集的工作流程分析和重新设计，全面的文档，按居民或居民人口汇编摘要信息，遵守临床指南，准确和及时地给药，以及持续审查和更改居民护理计划，以满足基于最佳实践的居民需求，从而改进临床实践。 3.使用HIT将以研究为基础的最佳做法融入日常工作，从而影响居民的健康结果。 综合评价将解决以下问题： HIT对住院医师的临床结果有什么影响：减少压疮、住院和减少约束措施的使用？ HIT对可预防的不良事件的影响是什么：体重减轻更少，ADL下降更少，药物不良事件更少？ 4.提炼和总结在养老院成功实施HIT的关键是什么的经验教训，包括促进者、障碍和解决这些障碍的战略。

DESCRIPTION (provided by the applicant): We propose to implement a health information technology (HIT) system with added best-practices decision support modules in seven nursing homes and evaluate the impact on care processes, resident health outcomes, and staff efficiency and satisfaction. The study will: 1. Lead a collaborative partnership to analyze and redesign clinical workflow, integrate research-based best practices into daily work using HIT to improve clinical practices, and sustain measurable improvements in health outcomes. 2. Implement and use HIT to improve clinical practice via user-friendly technology coupled with intensive workflow analysis and redesign, comprehensive documentation, compilation of summary information by resident or resident population, adherence to clinical guidelines, accurate and timely medication administration, and ongoing review and changes to resident plan of care to meet resident needs based on best practices. 3. Impact resident health outcomes by integrating research-based best practices into daily work using HIT. Comprehensive evaluation will address: a. What is the impact of HIT on resident clinical outcomes: fewer pressure ulcers, fewer hospitalizations, and less use of restraints? b. What is the impact of HIT on preventable adverse events: less weight loss, less decline in ADLs, fewer adverse drug events? 4. Distill and summarize lessons learned about what is critical for successful implementation of HIT in nursing homes, including facilitators, barriers, and strategies to address them.