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Team Performance and Quality of Care in Nursing Homes

疗养院的团队绩效和护理质量

基本信息

批准号：
7478565
负责人：
HELENA TEMKIN-GREENER
金额：
$ 26.25万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-01 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7478565
关键词：
Address Admission activity Age Area Attenuated Budgets Caregivers Certification Cessation of life Characteristics Communication Communities Conflict (Psychology)Congresses Data Data Analyses Data Set Decubitus ulcer Deterioration Dimensions Discipline of Nursing Disease regression Drug usage Effectiveness Exhibits Home Nursing Care Individual Information Dissemination Institute of Medicine (U.S.)Intervention Interview Knowledge Leadership Long-Term Care Nursing Malnutrition Marketing Measures Modeling New York Nursing Homes Online Systems Outcome Pain Patient Care Patients Pattern Performance Provider Public Policy Quality of Care Rate Recommendation Registered nurse Reporting Research Research Personnel Resources Rest Risk Risk Factors Sampling Score Series Services Statutes and Laws Surveys System Techniques Testing Time United States Urinary Incontinence Variant Workplace base cohesion experience functional status improved innovation insight organizational structure programs skills therapy design

项目摘要

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)：拟议研究的目标是评估疗养院团队的表现，并调查团队绩效对患者护理结果的影响。在养老院以外的环境中进行的研究表明，团队表现和风险调整后的患者结果之间存在着强烈的关系。如果这种关系可以在疗养院被记录下来，那么通过识别和传播关于示范团队实践的信息，就有很大的潜力来改善患者护理的质量。分析的概念模型依赖于多纳贝迪安提出的质量范式和从Shorten改编的因果模型。这项研究将随机抽取纽约州375家养老院作为样本，预计参与率为60%。护理质量将根据三个结果进行评估--功能状态、压疮和尿失禁。团队绩效将从六个维度进行衡量--领导力、沟通、协调、冲突管理、团队凝聚力和团队效能。主要数据将通过调查和访谈获得。次级数据将包括最低数据集(MDS)、在线调查认证和报告系统(OSCAR)和地区资源文件(ARF)。数据分析将包括多元回归技术，以测试关于团队绩效的特定假设，以及团队绩效与每个结果的其他结构变量之间的关联，控制进入养老院时存在的个人风险因素。从这项研究中获得的信息尤其及时，因为人们对养老院护理质量的担忧仍在继续，而且对养老院工作人员配备和人员流动的担忧加剧。到目前为止，关于护理质量和组织或劳动力因素之间的关系的研究大多是轶事。从这项研究中获得的经验性见解可用于测试和评估工作场所创新和公共政策干预，旨在提高劳动力保留率和质量，从而提高病人护理的质量。