The Quality of Emergency Care and and Relationship to Patient-Reported Outcomes

急诊护理的质量及其与患者报告结果的关系

• 批准号: 8501320
• 负责人: MELISSA L MCCARTHY
• 金额: $ 14.84万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8501320
• 关键词: Quality; Emergency; Care; Relationship; Patient

DESCRIPTION (provided by applicant): A recent report by the Institute of Medicine's (IOM) Committee on the Future of Emergency Care characterized hospital-based emergency care in the US as "at the breaking point." As a result of the mismatch between demand for emergency department (ED) services and the resources needed to provide them, many EDs in the US are struggling to provide quality emergency care to the patients who present to them. The short and long-term goals of this application are to contribute to research on the quality of ED care by identifying factors that influence patient safety, timeliness, effectiveness and efficiency of EDcare, implementing and evaluating promising interventions to improve the quality of ED care and becoming an independent investigator. To achieve these goals, my career development plan includes the following components: (1) identification of senior mentors and collaborators who will advise me; (2) acquisition of new skills through formal coursework; (3) attendance at quality of care meetings within the institution as well as national conferences; and (4) conduct of research projects that will advance my expertise in this area. There are 2 research projects proposed. The first one has two phases. Phase 1 will examine relationship among patient, provider and system factors that and the quality of ED care using a retrospective cohort design that involves review of electronic medical record data for approximately 2,500 patients who present to the ED with chest or abdominal pain during a 15 month period. In phase 2, we will use a prospective cohort design to examine the relationship between the quality of care received for 1,260 ED patients with chest or abdominal pain and patient-reported outcomes, specifically self-reported health, patient satisfaction with the ED visit and compliance with ED discharge instructions. Subjects in phase 2 will be interviewed during their index ED visit and one week later. The final project will pilot an intervention designed to improve the quality of ED care. The research environment is highly supportive of the goals of this application. I will collaborate with several quality and safety research groups within the institution. I will also work closely with members of my department to develop a proactive, quality of care surveillance program for our health system.

描述（由申请人提供）：医学研究所（IOM）紧急护理未来委员会最近的一份报告将美国以医院为基础的紧急护理描述为“处于临界点”。由于对急诊科（ED）服务的需求与提供这些服务所需的资源之间的不匹配，美国的许多急诊科正在努力为前来就诊的患者提供高质量的急诊护理。本申请的短期和长期目标是通过确定影响患者安全性、及时性、有效性和效率的因素，实施和评估有希望的干预措施以提高ED护理质量，并成为独立的研究者，为ED护理质量的研究做出贡献。为了实现这些目标，我的职业发展规划包括以下内容：(1)确定资深导师和合作者，他们会给我提供建议；(2)通过正规课程获得新技能；（三）参加机构内的护理质量会议和全国性会议；(4)开展研究项目，提高我在这一领域的专业知识。提出2个研究项目。第一个有两个阶段。第一阶段将采用回顾性队列设计，检查患者、提供者和系统因素与急诊科护理质量之间的关系，该设计涉及对约2,500名在15个月内因胸痛或腹痛就诊的急诊科患者的电子病历数据进行审查。在第二阶段，我们将采用前瞻性队列设计来检查1260例胸腹疼痛的急诊科患者所接受的护理质量与患者报告的结果之间的关系，特别是自我报告的健康状况、患者对急诊科就诊的满意度和对急诊科出院指示的依从性。第二阶段的受试者将在他们的索引ED访问期间和一周后进行访谈。最后的项目将试点一项旨在提高急诊科护理质量的干预措施。研究环境是高度支持这个应用程序的目标。我将与机构内的几个质量和安全研究小组合作。我还将与我的部门成员密切合作，为我们的卫生系统制定一个积极主动的、高质量的护理监督计划。

项目成果

Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

提供处方信息或服务是否可以提高急诊科出院患者的用药依从性？

• DOI: 10.1016/j.annemergmed.2013.02.002
• 发表时间: 2013
• 期刊: Annals of emergency medicine
• 影响因子: 6.2
• 作者: McCarthy,MelissaL;Ding,Ru;Roderer,NancyK;Steinwachs,DonaldM;Ortmann,MelindaJ;Pham,JuliusCong;Bessman,EdwardS;Kelen,GaborD;Atha,Walter;Retezar,Rodica;Bessman,SaraC;Zeger,ScottL
• 通讯作者: Zeger,ScottL

Impact of Subsidized Health Insurance Coverage on Emergency Department Utilization by Low-income Adults in Massachusetts.

补贴健康保险覆盖范围对马萨诸塞州低收入成年人使用急诊室的影响。

• DOI: 10.1097/mlr.0000000000000279
• 发表时间: 2015
• 期刊: Medical care
• 影响因子: 3
• 作者: Lee,Jennifer;Ding,Ru;Zeger,ScottL;McDermott,Aidan;Habteh-Yimer,Getachew;Chin,Michael;Balder,RebeccaS;McCarthy,MelissaL
• 通讯作者: McCarthy,MelissaL