Interprofessional Perinatal Consults to Improve Communication Quality, Satisfaction, and Team Cohesion: A Randomized Controlled Trial of the Collaboration for Antepartum Risk Evaluation (CARE) Model

跨专业围产期咨询可提高沟通质量、满意度和团队凝聚力：产前风险评估 (CARE) 模型合作的随机对照试验

• 批准号: 9313601
• 负责人: Julia C Phillippi
• 金额: $ 14.03万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9313601
• 关键词: Interprofessional; Perinatal; Consults; Improve; Communication

PROJECT ABSTRACT/SUMMARY Perinatal outcomes in the United States rank below many other developed countries. National organizations, such as the American College of Obstetricians and Gynecologists, have called for women to utilize the level and provider of maternity services that meet their personal and medical needs. This leveled approach to care requires consultation and collaboration among providers to ensure women receive appropriate services. While national and international organizations have called for team-based maternity care, current models can fragment services, increasing the risk of communication errors. Women can feel disenfranchised by models that do not meet their needs and opt out of beneficial services altogether. Currently, there is not evidence on effective interdisciplinary models of maternity care. The Collaboration for Antepartum Risk Evaluation (CARE) study will use a randomized design to systematically test the effect of interdisciplinary consults on women and providers. The two aims of the study are: (1) evaluate the effect of collaborative vs individual consults on participant outcomes including communication quality (using the Communication Assessment Tool, team version), maternal satisfaction (using a modified Satisfaction with Prenatal Care measure), semi-structured interviews, adherence to the developed plan of care, and perinatal outcomes; (2) evaluate the effect of the CARE clinic on providers using the Communication Assessment Tool team version, the AHRQ TeamSTEPPS Teamwork perceptions questionnaire, and semi-structured interviews. The award will support three years of research, training, and mentoring to assist Dr. Phillippi in becoming an independent investigator in patient- centered health services research. The career development plan will expedite independence by increasing her knowledge of: (1) design and conduct of implementation research, (2) maternal-child and interdisciplinary health research, and (3) comparative effectiveness methods and measures to test patient-centered care and communication. The plan includes research on the CARE model, targeted coursework, training in responsible conduct of research, and structured mentoring. Dr. Phillippi's interdisciplinary mentorship team includes national leaders in health services, implementation, and women's health research as well as experts in biostatistics and publication. These diverse and experienced mentors will meet regularly with Dr. Phillippi to provide guidance. Vanderbilt has a wealth of resources for new investigators including lectures, research communities, and expert assistance, resulting in a K to R (equivalent) conversion rate of 72%. Vanderbilt's extensive digital infrastructure, including an integrated electronic medical records system and a secure, HIPAA-compliant research platform, facilitate health services research. The CARE study will provide valuable information on effective models for patient-centered maternity care. The AHRQ K08 will allow Dr. Philippi to implement the CARE study and facilitate her growth into a national leader in midwifery and health services research.

项目摘要/总结 美国的围产期结局低于许多其他发达国家。国家组织， 美国妇产科医师学会等组织呼吁女性利用该水平 并提供满足其个人和医疗需求的产妇服务。这种分级护理方法 需要提供者之间进行协商和合作，以确保妇女获得适当的服务。尽管 国家和国际组织呼吁以团队为基础的产妇护理，当前的模式可以 碎片化服务，增加了通信错误的风险。女性可能会觉得自己被模特剥夺了权利 不能满足他们的需求并完全选择退出有益的服务。目前，尚无证据表明 有效的产妇护理跨学科模式。产前风险评估 (CARE) 合作 研究将采用随机设计来系统地测试跨学科咨询对女性和女性的影响 提供商。该研究的两个目的是：（1）评估协作咨询与个人咨询的效果 参与者的成果，包括沟通质量（使用沟通评估工具、团队 版本），产妇满意度（使用修改后的产前护理满意度衡量标准），半结构化 访谈、遵守制定的护理计划以及围产期结局； (2) 评估效果 使用沟通评估工具团队版本 AHRQ TeamSTEPPS 为提供者提供 CARE 诊所 团队合作认知调查问卷和半结构化访谈。该奖项将支持三年 研究、培训和指导，以协助 Phillippi 博士成为患者领域的独立调查员 以卫生服务研究为中心。职业发展计划将通过增加她的独立性来加速她的独立性。 了解：(1) 实施研究的设计和进行，(2) 母婴和跨学科 健康研究，以及（3）比较有效性方法和措施，以测试以患者为中心的护理和 沟通。该计划包括对 CARE 模式的研究、有针对性的课程作业、负责任的培训 进行研究和结构化指导。 Phillippi 博士的跨学科导师团队包括 卫生服务、实施和妇女健康研究方面的国家领导人以及专家 生物统计学和出版。这些多元化且经验丰富的导师将定期与 Phillippi 博士会面，以 提供指导。范德比尔特大学为新研究人员提供丰富的资源，包括讲座、研究 社区和专家协助，K 到 R（当量）的转化率为 72%。范德比尔特 广泛的数字基础设施，包括集成的电子病历系统和安全、 符合 HIPAA 要求的研究平台，促进健康服务研究。 CARE 研究将提供有价值的 有关以患者为中心的产妇护理的有效模式的信息。 AHRQ K08 将使 Philippi 博士能够 实施 CARE 研究并促进她成长为助产和卫生服务领域的全国领导者 研究。