Development of Dashboards to Provide Feedback to Home Care Nurses

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 DESCRIPTION (provided by applicant): This project proposes to design and carry out a usability evaluation of dashboards; a form of health information technology which use visualization techniques to provide feedback to clinicians on performance. In 2010 approximately 12 million individuals received care from home health agencies, a number that is projected to increase as the US population ages. Around two thirds of patient's receiving home care are funded through Medicare or Medicaid, making the Centers for Medicare & Medicaid Services (CMS) a key stakeholder with an interest in the quality of care home care patients receive. The CMS have been reporting outcome indicators for home care organizations since 2004, with the assumption that through the provision of feedback to home care agencies on their performance, they will engage in quality improvement strategies. In this study we propose to focus providing feedback on quality performance measures related to the care of patients with chronic heart failure (CHF). Patients with a diagnosis of CHF are at an increased risk of hospitalization, which is an outcome monitored by CMS that has not significantly improved since the CMS began reporting outcome metrics. We propose to use data visualization techniques, through the use of dashboards, to provide feedback to home care nurses that they can action to improve the care of patients with CHF. This study will develop the dashboard technology, using Feedback Intervention Theory to guide the development process, to produce a prototype that is flexible, dynamic and individualized to the nurse user. The specific aims of the study are: 1) Operationalize quality performance metrics related to the management of patients with CHF that can be used by individual home care nurses to improve their practice. 2) Provide feedback to home care nurses which maximizes their comprehension of the data. 3) Develop a set of flexible, dynamic quality dashboards individualized to nurse user preferences The study will use a mixture of methods to address these aims including focus groups, a multifactorial experimental study and a usability evaluation (including interviews and surveys with nurse users, heuristic evaluation and task analysis). The multidisciplinary research team represents an institutional collaboration between the VNSNY Center for Home Care Policy and Research and Columbia University Medical Center, and is uniquely positioned to carry out this proposed study. The dashboards developed in this study will be the focus of future research studies evaluating the impact of their use on the quality of care provided by clinicians in home health care settings.