Home Excellence Research and Outcomes Center to Advance, Redefine and Evaluate Non-institutional Caregiving (HERO CARE)

卓越家庭研究和成果中心推进、重新定义和评估非机构护理 (HERO CARE)

• 批准号: 9947748
• 负责人: Stuti Dang
• 金额: --
• 依托单位: SOUTH TEXAS VETERANS HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-10-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9947748
• 关键词: Address; Age; Assessment tool; Caregiver support; Caregivers; Caring; Communities; Data; Educational Curriculum; Elements; Ensure; Evaluation; Feedback; Goals; Growth; Health Services; Healthcare Systems; Home; Individual; Intervention; Knowledge; Leadership; Learning; Modeling; Outcome; Performance; Policies; Population; Production; Provider; Readiness; Recommendation; Research; Research Personnel; Resources; Rural Community; Services; Shapes; Site; System; Training; Urban Community; Veterans; Voice; Work; care delivery; care systems; caregiving; chronic care model; community based care; community based service; disability; effectiveness implementation study; empowered; improved; innovation; meetings; military veteran; multidisciplinary; patient population; programs; service programs

The goal of the Home Excellence Resource Center to Advance, Redefine, and Evaluate Non- Institutional Care (HERO CARE) Center of Excellence is to expand the capacity of the VA to deliver integrated, Veteran- and caregiver-partnered, data-driven approaches to non-institutional care across VA. The VA cares for Veterans across a wide range of disabilities and ages whose care requires the involvement of caregivers and use of home- and community-based services. Yet information regarding which Veterans are most likely benefit from which types of care is lacking, current systems of treatment delivery too often fail to meet the needs of Veterans and caregivers, services available are often limited due to local facility resource lack or mismatch, and a comprehensive system for implementing, evaluating, and disseminating best practices through VA operational offices has not been fully developed. Using an adaptation of the chronic care model as our theoretical framework, we propose a set of aims that will enable the VA to provide the most appropriate and effective non-institutional care matched to each Veteran’s needs and circumstances. Our work supports the rapid production of knowledge, using shared metrics and data as a common platform for evaluation and feedback, with the goal of empowering Veterans, caregivers, VA and non-VA providers, and leadership in making informed choices regarding care services and program planning. Our specific aims are as follows: Aim 1: Pilot innovative interventions to improve non-institutional care at each of the four VAMCs involved in this proposal, using a hybrid implementation / effectiveness approach to evaluate feasibility and impact. Our pilots will be conducted by each site in partnership with the Innovation Core, focusing on coordination between Veterans and caregivers, as well as between VA and non-VA care. Aim 2: Develop and validate stakeholder-driven outcome and performance metrics to aid in evaluating home- and community-based care programs and delivery across VA. This aim will be led by the Outcomes and Implementation (O&I) Core. Aim 3: Determine the optimal clusters of non-institutional care delivery elements for different Veteran populations. The Data and Policy (D&P) Core will oversee modeling efforts to determine the most effective non-institutional care elements for different populations. Aim 4: Integrate findings and deliverables from across these aims to develop a toolkit that can be used across VA to improve non-institutional care. Toolkit components will include curricula for training and delivery of best practices in home- and community-based care, a stakeholder-driven set of outcome and performance metrics, a local site needs and readiness assessment tool, and recommendations for implementation of specific programs and program types, and will be packaged for VA-wide dissemination by the O&I Core. Our multi-disciplinary team of clinicians and health services researchers across four VAMCs will work in tandem to ensure the HERO CARE Center of Excellence serves as a model for excellence in training, innovation, evaluation, implementation and spread of best practices in non-institutional care across VA and beyond. The resulting work will enable a cycle of improvement that is vital to the VA transformation to a Learning Health Care System, and that will enable VA to meet the needs of Veterans and caregivers in the decades to come.

卓越家居资源中心的目标是推进、重新定义和评估非 机构关怀(英雄关怀)卓越中心是为了扩大退伍军人管理局的能力，提供 由老兵和护理员合作、以数据为导向的集成方法，可在 弗吉尼亚州退伍军人管理局照顾需要照顾的各种残疾和年龄段的退伍军人 照顾者的参与以及家庭和社区服务的使用。然而，关于哪些方面的信息 退伍军人最有可能受益于缺乏哪种类型的护理，目前的治疗提供系统也是如此 往往无法满足退伍军人和照顾者的需求，可提供的服务往往由于当地设施的限制而受到限制 资源缺乏或不匹配，以及实施、评估和传播最佳方案的综合系统 通过退伍军人事务部业务办事处的做法尚未得到充分发展。 使用慢性护理模式的改编作为我们的理论框架，我们提出了一套目标，将 使退伍军人管理局能够提供与每个退伍军人相匹配的最适当和最有效的非机构护理 需求和环境。我们的工作支持知识的快速生产，使用共享的指标和 数据作为评估和反馈的公共平台，目标是增强退伍军人、照顾者、退伍军人和退伍军人 和非退伍军人管理局提供商，并在做出有关护理服务和计划的明智选择方面发挥领导作用 计划。我们的具体目标如下： 目标1：试点创新干预措施，以改善四个国家的非医疗机构护理 参与本提案的可变资产管理公司，使用混合实施/有效性方法进行评估 可行性和影响力。我们的试点将由每个站点与创新核心合作进行， 侧重于退伍军人和照顾者之间以及退伍军人和非退伍军人护理之间的协调。 目标2：开发和验证利益相关者驱动的结果和绩效指标，以帮助 评估以家庭和社区为基础的护理计划和整个退伍军人事务部的服务。这一目标将由 结果和执行(O&I)核心。 目标3：确定非机构护理提供要素的最佳集群，以满足不同的需求 退伍军人。数据和政策(D&P)核心将监督建模工作，以确定 为不同人群提供有效的非机构护理要素。 目标4：整合来自这些目标的结果和交付成果，以开发一个工具包，该工具包可以 在退伍军人事务部使用，以改善非机构护理。工具包组件将包括培训课程 以及提供以家庭和社区为基础的护理的最佳实践、利益相关者驱动的一套成果和 性能指标、本地站点需求和就绪性评估工具，以及 实施特定方案和方案类型，并将打包在退伍军人管理局范围内传播 O&I核心。 我们由四个VAMC的临床医生和卫生服务研究人员组成的多学科团队将在 确保卓越英雄关怀中心成为卓越培训的典范， 创新、评估、实施和推广退伍军人管理局和 更远一点。由此产生的工作将实现对退伍军人管理局向 学习卫生保健系统，这将使退伍军人管理局满足退伍军人和护理人员的需求 几十年后。