Nursing Home IT: Optimal Medication and Care Delivery

描述（由申请人提供）：我们建议实施一个健康信息技术（HIT）系统，在七个养老院中添加最佳实践决策支持模块，并评估对护理流程，居民健康结果以及员工效率和满意度的影响。该研究将： 1.领导合作伙伴关系，分析和重新设计临床工作流程，将基于研究的最佳实践整合到日常工作中，使用HIT改善临床实践，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，加上密集的工作流程分析和重新设计，全面的文件，按居民或常住人口汇总信息的汇编，遵守临床指南，准确和及时的药物管理，以及不断审查和更改居民护理计划，以满足居民的需求，以最佳实践为基础，改善临床实践。 3.通过使用HIT将基于研究的最佳实践融入日常工作，影响居民健康结果。 全面评价将涉及： a. HIT对住院医师临床结局的影响是什么：更少的压疮、更少的住院和更少的约束使用？ B. HIT对可预防的不良事件有何影响：体重减轻较少，ADL下降较少，药物不良事件较少？ 4.提取和总结经验教训，了解在养老院成功实施HIT的关键是什么，包括促进者，障碍和解决这些问题的策略。

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.