Translating Team Science into Primary Care: PCOR on teamwork in FQHCs

将团队科学转化为初级保健：PCOR 关于 FQHC 中的团队合作

• 批准号: 8599628
• 负责人: Kevin Fiscella
• 金额: $ 17.39万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8599628
• 关键词: Translating; Team; Science; into; Primary

Ensuring that patients, particularly those who are socially disadvantaged, have a meaningful voice in their healthcare while also ensuring they receive high value care, requires new Patient-Centered Outcomes Research (PCOR). Optimizing patients' voice and value in primary care requires transformation of healthcare delivery from care by lone clinicians to care by teams. This career enhancement proposal is designed to provide me with the mentoring, skills, experiences, and partnerships necessary to re-focus my research on this new area of PCOR, i.e. translation of teamwork science into primary care, particularly within federally qualified health centers (FQHCs). I will achieve this aim through stakeholder collaboration, including refining, piloting, and evaluating the Patient-Teamlet Communication (PTC) model. This new model, based on teamlets (teams of clinicians and nursing staff), integrates the science of patient-centered communication with the science of teamwork. The project aim builds on the work of my renowned mentors and consultants and will be accomplished through guided self-study, offsite and onsite training, and application of PCOR methods to piloting of the PTC model within an FQHC. The PTC model enhances patients voice and value by focusing on critical taskwork and teamwork during primary care office visits, including elicitation of patient concerns and preferences and team-based delivery of evidence-based preventive care and other high value processes. The model focuses on the following key office visit processes: pre-visit planning, team huddles and debriefing, team use of clinical decision support systems, full elicitation of patients concerns, and post-visit confirmation of understanding and planning. The proposed project will develop training modules using feasible strategies relevant to FQHCs. My specific educational objectives are: 1) To enhance my skills in direct observation of primary care visits with a focus on tasks and teamwork; 2) To acquire teamwork training skills applicable to primary care; 3) To enhance my skills relevant to stakeholder and patient engagement; 4) To acquire teamwork assessment skills. My specific research aims are: 1)To refine and pilot the PTC model within an FQHC; 2) To pilot key PCOR measures relevant to facets of the PTC model; 3) To examine key facilitators and barriers to implementation of the PTC model. Achievement of these educational and research aims will provide me with the experiences, skills, partnerships, measures, and preliminary data necessary to launch inquiry into this entirely new area of PCOR. This research offers the promise for transforming care for millions of underserved and socially disadvantaged patients served by FQHCs and for reducing health care disparities.

确保患者，特别是那些处于社会弱势地位的患者，在医疗领域拥有有意义的发言权 他们的医疗保健同时确保他们获得高价值护理，需要新的以患者为中心的成果 研究（PCOR）。优化患者在初级保健中的声音和价值需要医疗保健转型 从单独临床医生的护理转向团队护理。该职业提升提案旨在 为我提供必要的指导、技能、经验和合作伙伴关系，使我的研究重新集中在 PCOR 的这个新领域，即将团队合作科学转化为初级保健，特别是在联邦范围内 合格的健康中心 (FQHC)。我将通过利益相关者的合作来实现这一目标，包括精炼、 试点和评估患者团队沟通 (PTC) 模型。这个新模型，基于 teamlets（临床医生和护理人员团队），整合了以患者为中心的沟通科学 与团队合作的科学。该项目的目标建立在我著名的导师和顾问的工作之上 并将通过引导自学、场外和现场培训以及 PCOR 的应用来完成 在 FQHC 内试点 PTC 模型的方法。 PTC 模型通过在治疗过程中关注关键任务和团队合作来增强患者的声音和价值。 初级保健办公室访问，包括询问患者的担忧和偏好以及基于团队的交付 基于证据的预防性护理和其他高价值流程。该模型重点关注以下关键 办公室访问流程：访问前计划、团队会议和汇报、团队使用临床决策支持 系统，充分引起患者的担忧，并在访问后确认理解和计划。这 拟议项目将使用与 FQHC 相关的可行策略开发培训模块。 我的具体教育目标是： 1) 提高直接观察初级保健的技能 重点关注任务和团队合作的访问； 2) 获得适用于初级保健的团队合作培训技能； 3） 提高我与利益相关者和患者参与相关的技能； 4) 获得团队合作评估 技能。 我的具体研究目标是： 1）在 FQHC 内完善和试点 PTC 模型； 2) 至先导键 与 PTC 模型的各个方面相关的 PCOR 措施； 3）检查关键的促进因素和障碍 PTC模型的实施。这些教育和研究目标的实现将为我提供 开展调查所需的经验、技能、伙伴关系、措施和初步数据 PCOR 的全新领域。这项研究为改变数百万服务不足的人的护理带来了希望 和 FQHC 服务的社会弱势患者并减少医疗保健差距。