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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

基本信息

批准号：
8706795
负责人：
Kevin Fiscella
金额：
$ 17.4万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-01 至 2015-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8706795
关键词：
Translating Team Science into Primary

项目摘要

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：确保患者，特别是那些处于社会弱势地位的患者，在他们的医疗保健中拥有有意义的声音，同时确保他们获得高价值的护理，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将医疗保健服务从单独的临床医生护理转变为团队护理。这份职业提升提案旨在为我提供必要的指导，技能，经验和合作伙伴关系，以重新关注我对PCOR这一新领域的研究，即将团队合作科学转化为初级保健，特别是在联邦合格的卫生中心（CIMCs）。我将通过利益相关者的合作来实现这一目标，包括完善、试点和评估患者-小团队沟通（PTC）模型。这种新的模式，基于小团队（临床医生和护理人员的团队），整合了以病人为中心的沟通科学与团队合作的科学。该项目的目标以我的著名导师和顾问的工作为基础，将通过有指导的自学、场外和现场培训以及将变革和组织振兴方案方法应用于在一个区域中心内试行技术合作与发展模式来实现。PTC模式通过在初级保健办公室访问期间专注于关键任务和团队合作来增强患者的声音和价值，包括引发患者的关注和偏好以及基于团队的循证预防护理和其他高价值流程。该模型侧重于以下关键的办公室访问过程：访问前的规划，团队会议和汇报，团队使用的临床决策支持系统，充分启发患者的关注，并在访问后确认的理解和规划。拟议的项目将利用与难民署有关的可行战略制定培训单元。我的具体教育目标是：1）提高我直接观察初级保健访问的技能，重点是任务和团队合作; 2）获得适用于初级保健的团队合作培训技能; 3）提高我与利益相关者和患者互动的技能; 4）获得团队合作评估技能。我的具体研究目标是：1）在技术合作和人力资源中心内完善和试行技术合作和人力资源管理模式; 2）试行与技术合作和人力资源管理模式各方面有关的变革和组织振兴方案关键措施; 3）审查技术合作和人力资源管理模式实施的关键促进因素和障碍。这些教育和研究目标的实现将为我提供必要的经验、技能、伙伴关系、措施和初步数据，以启动对变革和组织振兴方案这一全新领域的调查。这项研究为数百万由CIMCs服务的服务不足和社会弱势患者提供了转变护理的承诺，并减少了医疗保健的差距。