Evaluating a Comprehensive State-Level Model to Improve Nursing Home Quality

描述(由申请人提供)：这个项目的目的是评估一个州级计划，以成本效益的方式促进高质量的养老院护理，并传播从该计划中学到的经验教训。明尼苏达州基于绩效的激励支付计划(PIPP)超越了传统的绩效薪酬计划，不仅提供财务激励，还为提供商提供提高绩效的工具。它使用竞争性的申请程序来资助创新的、由提供者发起的项目，这些项目满足了以降低不必要成本的方式提高养老院质量的计划目标。评估将确定导致质量改进成功实施和可持续性的因素，确定提供者和国家的有形或无形利益，并在养老院行业传播有效的质量改进项目。评价将通过以下方法进行：对提供者的全面调查，包括参与资助的PIPP项目的提供者，申请PIPP但没有资助的提供者，以及没有申请的提供者。对20个获得资助的PIPP项目进行深入的组织分析和业务案例研究，以确定哪些因素有助于项目的成功实施和投资回报。对养老院质量数据进行量化分析，比较PIPP和非PIPP设施在养老院质量方面的变化趋势。从州和消费者的角度分析PIPP计划的好处、成本和财政影响。该项目将为当地和全国的养老院和资助机构提供PIPP工具包和其他质量改进资源。 公共卫生相关性：这项研究将通过确定导致养老院质量改进项目成功实施和持续的组织结构、流程和文化因素，评估国家投资于质量改进的理由，并确定通过改善医疗保健的价值可能实现的医疗补助和资金来源的节省，从而促进公共卫生。此外，在全国范围内传播提高养老院质量和价值的方法对养老院消费者、长期护理行业和政府资助机构非常重要。

DESCRIPTION (provided by applicant): The aims of this project are evaluate a state-level program to promote quality nursing home care in a cost-effective manner and to disseminate lessons learned from this program. Minnesota Performance-Based Incentive Payment Program (PIPP) moves beyond conventional pay for performance programs to not only offer financial incentives but also to equip providers with the tools to increase their performance. It uses a competitive application process to fund innovative, provider-initiated projects which meet the program goal of improving nursing home quality in a manner which reduces unnecessary costs. The evaluation will identify factors that lead to successful implementation and sustainability of quality improvement, identify tangible or intangible benefits to providers and the state, and disseminate effective quality improvement projects across the nursing home industry. The evaluation will be achieved through the following methods: A comprehensive survey of providers, including providers who participated in a funded PIPP project, providers who applied for PIPP but were not funded, and providers who did not apply. In-depth organizational analysis and business case study of 20 funded PIPP projects to determine what factors contributed to successful project implementation and return on investment. Quantitative analysis of nursing home quality data to draw comparisons between PIPP and non-PIPP facilities in their trends of nursing home quality. Analysis of PIPP program benefits, costs, and fiscal impact from both a state and consumer's perspective. The project will result in a PIPP toolkit and other quality improvement resources for nursing homes and funding agencies both locally and nationally. PUBLIC HEALTH RELEVANCE: This research will advance public health by identifying organizational structure, process, and cultural factors that lead to successful implementation and sustainability of nursing home quality improvement projects, assessing the case for state investment in quality improvement, and determining the savings to Medicaid and funding sources potentially achieved by improving upon the value of healthcare. Additionally, national dissemination of methods to enhance nursing home quality and value is of importance to nursing home consumers, the long term care industry, and governmental funding agencies.