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Hospital Adoption of Models of Care and Practices for Older Adults and Its Impact

医院对老年人的护理和实践模式的采用及其影响

基本信息

批准号：
8821764
负责人：
William W.,MPH, MD Hung
金额：
$ 75.44万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8821764
关键词：
Hospital Adoption Models Care Practices

项目摘要

DESCRIPTION (provided by applicant): Older adults, the fastest growing segment of the population, are more prone to acute illnesses, and account for a disproportionately high number of hospital acute care admissions and hospital days. They are also particularly at risk for adverse events such as hospital acquired infections, delirium, falls, and pressure ulcers during inpatient hospitalization. To improve care delivery for older adults and reduce risk of adverse outcomes, several models of care targeting hospitalized older adults have been developed. These models include dedicated units or teams for older adults, delirium prevention models, and transitional care programs to prevent lapses when patients are discharged from the hospital; they have been shown to be effective in improving patient safety and quality of care. Although these models and practices may improve quality of care among older adults, little is known about how hospitals across the country have adopted them in their care delivery systems. As increasing attention has been placed on hospital performance in patient care, understanding how hospitals implement care models and practices of care to improve quality and how these models and practices relate to health outcomes would be an important step toward guiding further efforts to transform care. In this study, we will develop a hospital survey tool to characterize services and processes of care adopted by hospitals to deliver care sensitive to older adults. We will apply this tool to a large number of hospitals across the country, utilizing n already established network-the Nurses Improving Care for Health system Elders (NICHE) network of over 400 hospitals. Using the survey data, we will develop a measure to describe the degree to which hospitals have adopted models and practices for older adults. We will compare hospitals on this measure and examine its relationship with patient outcomes. Such measures may also allow for the examination of regional variations and variations over time.

描述（由申请人提供）：老年人是人口中增长最快的部分，他们更容易患急性疾病，并且在医院急诊住院和住院天数中占不成比例的高数量。他们在住院期间也特别容易发生不良事件，如医院获得性感染、谵妄、跌倒和压疮。为了改善老年人的护理服务并降低不良后果的风险，已经开发了几种针对住院老年人的护理模式。这些模式包括专门针对老年人的单位或团队、谵妄预防模式和过渡性护理计划，以防止患者出院时出现失误；它们已被证明在改善患者安全和护理质量方面是有效的。尽管这些模式和做法可能会提高老年人的护理质量，但人们对全国各地的医院如何在其护理服务系统中采用这些模式和做法知之甚少。随着人们越来越关注医院在病人护理方面的表现，了解医院如何实施护理模式和护理实践以提高质量，以及这些模式和实践如何与健康结果相关联，将是指导进一步努力改变护理的重要一步。在本研究中，我们将开发一种医院调查工具，以表征医院采用的服务和护理过程，以提供对老年人敏感的护理。我们将利用已经建立的网络——由400多家医院组成的护士改善健康系统老年人护理（NICHE）网络，将这一工具应用于全国大量医院。利用调查数据，我们将制定一项措施来描述医院采用老年人模型和做法的程度。我们将比较医院的这一措施，并检查其与患者结果的关系。这些措施也可能允许审查区域差异和随时间的变化。