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不利的患者，在 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结果 研究（PCOR）。优化患者在初级保健中的声音和价值需要改造医疗保健 从孤独的临床医生的护理服务到团队的护理。这项职业增强建议旨在 为我提供所需的指导，技能，经验和伙伴关系，以重新聚焦我的研究 PCOR的这个新领域，即将团队合作科学转化为初级保健，尤其是在联邦内部 合格的卫生中心（FQHC）。我将通过利益相关者的合作，包括精炼， 试行并评估患者团队通信（PTC）模型。这个新模型，基于 Teamlets（临床医生和护理人员团队），整合以患者为中心的沟通的科学 与团队合作科学。该项目的目的是建立在我著名的导师和顾问的工作的基础上 并将通过指导的自学，异地和现场培训以及PCOR的应用来完成 FQHC中PTC模型试验的方法。 PTC模型通过专注于关键任务工作和团队合作，从而增强患者的声音和价值 初级保健办公室就诊，包括引起患者的关注和偏好以及基于团队的送达 基于证据的预防保健和其他高价值过程。该模型关注以下密钥 办公室访问流程：访问前的计划，团队障碍和汇报，团队使用临床决策支持 系统，对患者的全面启发以及对理解和计划后的访问确认。这 拟议的项目将使用与FQHC相关的可行策略开发培训模块。 我的具体教育目标是：1）提高我直接观察初级保健的技能 访问以任务和团队合作为重点； 2）获得适用于初级保健的团队合作培训技能； 3） 增强我与利益相关者和患者参与度相关的技能； 4）获得团队合作评估 技能。 我的具体研究目的是：1）在FQHC中完善和驾驶PTC模型； 2）驾驶钥匙 PCOR测量与PTC模型的方面相关； 3）检查关键的促进者和障碍 PTC模型的实现。这些教育和研究目标的实现将为我提供 对此进行询问所需的经验，技能，伙伴关系，措施和初步数据 全新的PCOR领域。这项研究提供了转变数百万服务不足的护理的希望 以及由FQHC服务和减少医疗保健差异的社会弱势患者。