Values and Evidence: Public input for hospital planning to improve community health

价值观和证据：公众对改善社区健康的医院规划的意见

• 批准号: 8798125
• 负责人: LINDA J WEISS
• 金额: $ 19.77万
• 依托单位: NEW YORK ACADEMY OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8798125
• 关键词: Values; Evidence; Public; input; hospital

DESCRIPTION (provided by applicant): There is widespread agreement that the health of Americans is poorer than that of other wealthy nations, that there are inequalities in health status and life expectancy affecting minority and socioeconomically disadvantaged populations, and that factors creating both health underachievement and disparate outcomes lie outside of the reach of the medical health care delivery system. Meaningful gains in population health require better public understanding and expanded institutional actions, which support changes in the social and physical environment. In accordance with New York State's 2013-2017 Prevention Agenda and consonant with requirements for not-for-profit hospitals contained in the Affordable Care Act, the Maimonides Medical Center in Brooklyn, New York has undertaken a comprehensive community health needs assessment (CHNA) that is intended to support implementation of actions that improve the health of the diverse catchment area it serves while striving to reduce racial, ethnic, and socioeconomic health disparities. Maimonides has worked with The New York Academy of Medicine (NYAM) in conducting the CHNA and now wishes to prioritize a set of evidence-based programs directed at improving population health for implementation within the community it serves. Maimonides is interested in using a deliberative methodology whereby members of the public will offer informed and value-based advice to the institution with respect to programs they view as having the highest utility to improve the health of the community. In response to this, NYAM proposes to implement three citizen panels comprised of 24-28 participants that will reflect the diversity of the population served by Maimonides. The results will be summarized in a report to Maimonides leadership that will provide informed public guidance for programmatic priorities and will be evaluated for process and outcomes at the individual and institutional level. The specific aims of the study are to (1) implement multiple public deliberative sessions that are responsive to the decision-making responsibilities of an urban medical center serving a diverse, largely minority community; (2) Assess the impact of the deliberative process on participant knowledge and attitudes about evidence, comparing pre and post participation; (3) Assess the quality and effectiveness of the deliberative sessions; and (4) Examine the institutional response to recommendations made by citizen panels, including acceptability of recommendations and barriers and facilitators to implementation Strengths of this proposal are a highly experienced team, as well as the full interest and engagement of Maimonides Medical Center, an institution needing to make key programmatic decisions to comply with new state and federal requirements, and to meet the needs of its community. We anticipate that our findings will inform Maimonides decision making and will offer lessons that will be widely disseminated and can be used by non-profit hospitals across the country with new mandates to effectively engage their communities in health care decision making and to promote and protect population health.

描述（由申请人提供）：人们普遍认为，美国人的健康状况比其他富裕国家差，健康状况和预期寿命不平等影响少数民族和社会经济弱势群体，造成健康不良和不同结果的因素超出了医疗保健提供系统的范围。要在人口健康方面取得有意义的进展，就需要公众有更好的理解，并扩大机构行动，以支持社会和物质环境的变化。根据《纽约州2013-2017年预防议程》，并与《平价医疗法案》中对非营利医院的要求相一致，纽约布鲁克林的迈蒙尼德医疗中心开展了一项全面的社区卫生需求评估（CHNA），旨在支持采取行动，改善其所服务的多样化集水区的健康，同时努力减少种族、族裔、族裔和宗教歧视。种族和社会经济健康差异。迈蒙尼德曾与纽约医学院（NYAM）合作开展CHNA，现在希望优先考虑一系列旨在改善人口健康的循证计划，以便在其服务的社区内实施。迈蒙尼德感兴趣的是使用一种审议的方法，使公众成员将提供知情和基于价值的建议，以机构就他们认为具有最高效用的方案，以改善社区的健康。针对这一点，NYAM建议设立三个由24-28名参与者组成的公民小组，以反映迈蒙尼德服务的人口的多样性。将在一份提交迈蒙尼德领导层的报告中总结结果，该报告将为方案优先事项提供知情的公众指导，并将在个人和机构层面对进程和成果进行评价。本研究的具体目的是：（1）实施多个公共审议会议，以响应城市医疗中心的决策责任，为多元化，主要是少数民族社区服务;（2）评估审议过程对参与者的知识和态度的影响，比较前后参与;（3）评估审议会议的质量和有效性;和（4）检查机构对公民小组提出的建议的反应，包括建议的可接受性以及实施的障碍和促进者。本提案的优势是一个经验丰富的团队，以及迈蒙尼德医疗中心的充分兴趣和参与，迈蒙尼德医疗中心是一个需要做出关键方案决策以符合新的州和联邦要求的机构，并满足其社区的需求。我们预计，我们的研究结果将为迈蒙尼德的决策提供信息，并将提供将被广泛传播的经验教训，并可供全国各地的非营利性医院使用，以有效地使其社区参与医疗保健决策，促进和保护人口健康。