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A Data-driven Approach to Improve Nursing Workflow and Patient-centered Care

改善护理工作流程和以患者为中心的护理的数据驱动方法

基本信息

批准号：
8740097
负责人：
WILLIAM Z TAN
金额：
$ 20万
依托单位：
TRANSCENDENT INTERNATIONAL, LLC
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：
2014-09-25 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8740097
关键词：
Accounting Achievement Adopted Adverse event American Care given by nurses Caring Case Study Censuses Cessation of life Chinese People Communication Communities Comprehensive Health Care Computer Terminals Country Data Decubitus ulcer Discipline of Nursing District of Columbia Documentation Elderly Ensure Environment Evaluation Event Faculty Feasibility Studies Floor Food Frequencies Guidelines Health Health Professional Health Services Healthcare Healthcare Systems Home environment Hospitals Human Resources Individual Inpatients Language Light Location Long-Term Care Marketing Mississippi Nature Nurses Nursing Informatics Nursing Staff Outcome Outcome Measure Pain Paper Patient Education Patient-Centered Care Patients Pattern Performance Phase Play Population Process Productivity Protocols documentation Provider Psychosocial Influences Quality of Care Reporting Research Retirement Risk Role Route Scientist Services Skilled Nursing Facilities Solutions Sturnus vulgaris System Tablets Testing Time Underserved Population United States Agency for Healthcare Research and Quality Universities Veterans Work Workload adverse outcome arm authority base biomedical informatics care delivery clinical practice cost direct patient care drinking empowered experience falls handheld mobile device health disparity improved innovation member patient oriented patient safety preference prevent prototype racial and ethnic satisfaction stem success task analysis tool touchscreen

项目摘要

DESCRIPTION (provided by applicant): Patient-centered care recognizes patients' desires, opinions, and preferences as equal in importance to those of healthcare professionals, and emphasizes the need to educate and empower patients to play an active role in their care. The achievement of patient-centered care is associated with increased patient and provider satisfaction, improved health outcomes, and reduced cost of care delivery (Caffarini, 2011; Silow-Carol et al., 2006; Wolf et al., 2008). Furthermore, as health disparities continue to persist, patient-centered care offers underserved patients the individualized and tailored care necessary to attain positive health outcomes. As the providers who spend more time with patients than any other personnel, nursing staff are central to the provision of patient-centered care (De Lucia et al., 2009). However, most of these front-line providers are burdened by numerous non-value added tasks that not only distract from direct patient care activities, but also hamper their ability to implement best practices such as proven care plans for preventing adverse events (e.g., falls and pressure ulcers) among at-risk patients (Hendrich et al., 2008; Storfjell et al., 2008; Aiken et al., 2002). The occurrence of such preventable events is especially concerning in light of the fact that such events fall disproportionately on already underserved populations, including certain racial/ethnic communities, limited English speaking individuals, and the elderly (Divi et al., 2007; Metersky et al., 2011; Rothschild et al., 2000). Fr patient-centered care to be truly realized, the healthcare system must introduce process innovations that can streamline mundane, indirect tasks such as service documentation for front-line nursing care providers and enable them to efficiently adopt value added clinical practices that benefit direct patient care activities. In this project, we will engage several partners-including a skilled nursing facility that serves predominantly monolingual Spanish- and Chinese-speaking communities and a long-term care facility for retired veterans-to implement an advanced patient-nurse communication and nurse workflow optimization system. This solution will: (i) track comprehensive care plans and associated tasks for individual patients; (ii intelligently assign and alert each provider of his or her care plan tasks, escalating pending tasks to appropriate staff members to expedite completion; and (iii) offer real-time analysis of task fulfillment status and workflow patterns, providing decision support to both staff and managers for identifying factors that may undermine staff productivity or contribute to adverse events.

描述（由申请人提供）：以患者为中心的护理认识到患者的愿望、意见和偏好与医疗保健专业人员的愿望、意见和偏好同等重要，并强调教育和授权患者在其护理中发挥积极作用的必要性。实现以患者为中心的护理与提高患者和提供者满意度、改善健康结果和降低护理成本相关（Caffarini, 2011； Silow-Carol等，2006；Wolf等，2008）。此外，由于健康差距继续存在，以患者为中心的护理为服务不足的患者提供个性化和量身定制的护理，以实现积极的健康结果。作为比其他人员花更多时间与患者在一起的提供者，护理人员是提供以患者为中心的护理的核心（De Lucia et al., 2009）。然而，这些一线医护人员大多承担着大量非增值任务，这些任务不仅分散了对患者的直接护理活动，而且妨碍了他们实施最佳实践的能力，例如在高危患者中预防不良事件（例如跌倒和压疮）的成熟护理计划（Hendrich et al., 2008; Storfjell et al., 2008; Aiken et al., 2002）。这些可预防事件的发生尤其令人担忧，因为这些事件不成比例地发生在服务不足的人群身上，包括某些种族/民族社区、有限的英语使用者和老年人（Divi et al., 2007; Metersky et al., 2011; Rothschild et al., 2000）。为了真正实现以患者为中心的护理，医疗保健系统必须引入流程创新，以简化日常的间接任务，如前线护理提供者的服务文档，并使他们能够有效地采用增值的临床实践，从而有利于直接的患者护理活动。在这个项目中，我们将与几个合作伙伴合作，包括一家主要服务于单语西班牙语和中文社区的熟练护理机构，以及一家面向退役老兵的长期护理机构，以实施先进的病人-护士沟通和护士工作流程优化系统。该解决方案将：(i)跟踪单个患者的综合护理计划和相关任务；（二）智能地分配和提醒每个提供者他或她的护理计划任务，将未完成的任务升级到适当的工作人员，以加快完成；（三）提供任务完成状况和工作流程模式的实时分析，为工作人员和管理人员提供决策支持，以确定可能损害工作人员生产力或导致不良事件的因素。