Starfield Summit: Developing a National Strategic Vision for Primary Care

星空峰会：制定国家初级保健战略愿景

• 批准号: 9323676
• 负责人: Rebecca Sarah Etz
• 金额: $ 3.37万
• 依托单位: VIRGINIA COMMONWEALTH 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 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9323676
• 关键词: Starfield; Summit; Developing; National; Strategic

Project Summary Background: The US Health Care System needs quality measures adequate to the task of assessing, valuing, and fostering continuous improvement within the fields of primary care. Policymakers and health care leaders have called for a reduction in the number of quality measures applied to primary health care. Reducing the number of primary care measures used will reduce administrative burden associated with measurement reporting. However, with a focus on adaption of current measures rather than redesign, these efforts fail to address the challenges endemic to our current measurement system. These challenges include: a myopic focus on disease-specific clinical processes and outcomes; measures reactive to the needs of policy and payment rather than proactively informed by health and healing; misrepresentation and underrepresentation of primary health care's contributions; a disconnect between health outcomes important to patients and those items being measured; and absence of a unified vision regarding what we should measure and why. In 1978, the World Health Organization (WHO) Alma-Ata conference established that robust primary health care is foundational to any high performing health care system. Barbara Starfield's 1994 identification of the key attributes of primary care – first contact, relationship-based continuity, whole person comprehensive care, and coordination – is globally accepted as standard. Despite clear definition and agreement regarding the function and attributes of primary care, our ability to define and identify quality in primary care remains elusive. Purpose: To develop a stakeholder informed operational definition for quality in primary care; to define a conceptual framework able to guide development of meaningful primary care measures; to identify key attributes and functions of primary care in which quality indicators are lacking; and to create a strategic plan for the development of meaningful measures actionable within the next year. Methods: We will bring together a unique combination of primary care stakeholders and leaders for a three- day conference that incorporates both large and small group discussion. Issue Briefs, designed around five basic questions will define each question, describe its importance, provide a bulleted account of best evidence to date, and suggest focused areas for group discussion. The five questions are: 1) what is quality in primary care, 2) what is the purpose of measuring it, 3) what would best practice for measurement five years from now look like, 4) what are the opportunities available or to be created for getting us there, and 5) who needs to be part of our community of solution. Benefit: Shifting the structure of quality primary care measures is possible and necessary for the successful revitalization of the US primary care system. This conference will be the first stakeholder-led effort to create a conceptual framework and unified vision able to assess and report the value of primary care to the national achievement of the Triple Aim: improved population health, better patient experience, and smarter spending.

项目摘要 背景：美国卫生保健系统需要足够的质量措施来评估，评价， 并促进初级保健领域的持续改进。政策制定者和医疗保健领导者 呼吁减少适用于初级卫生保健的质量措施的数量。减少 所采用的一些初级保健措施将减少与测量有关的行政负担 报告.然而，由于侧重于调整现行措施而不是重新设计，这些努力未能 解决我们目前的测量系统所特有的挑战。这些挑战包括：近视 重点关注特定疾病的临床过程和结果;应对政策和 支付，而不是主动告知健康和愈合;误报和漏报 初级卫生保健的贡献;对患者重要的健康结果与那些 项目被测量;以及缺乏关于我们应该测量什么和为什么测量的统一愿景。一九七八年， 世界卫生组织（世卫组织）阿拉木图会议确定， 这是任何高性能医疗保健系统的基础。芭芭拉·斯塔菲尔德1994年对钥匙的鉴定 初级保健的属性-第一次接触，关系为基础的连续性，全人综合护理， 协调-是全球公认的标准。尽管有明确的定义和关于职能的协议， 和基层医疗的属性，我们的能力，界定和确定基层医疗质量仍然难以捉摸。 目的：为初级保健质量制定一个利益相关者知情的操作定义; 能够指导制定有意义的初级保健措施的概念框架; 缺乏质量指标的初级保健的属性和功能;并制定一项战略计划， 制定有意义的措施，可在明年内采取行动。 方法：我们将汇集初级保健利益相关者和领导者的独特组合，为三个- 一天的会议，包括大型和小型小组讨论。问题简介，设计围绕五个 基本问题将定义每个问题，描述其重要性，提供最佳证据的项目符号说明 到目前为止，并提出了小组讨论的重点领域。这五个问题是：1）什么是小学教育质量 护理，2）测量它的目的是什么，3）从现在起五年内测量的最佳实践是什么 看起来像，4）有什么机会可以让我们到达那里，5）谁需要 我们解决方案社区的一部分。 好处：改变优质初级保健措施的结构是可能的，也是必要的， 振兴美国的初级保健系统。这次会议将是第一次由股东领导的努力， 概念框架和统一的愿景，能够评估和报告初级保健的价值， 实现三重目标：改善人口健康，改善患者体验和更明智的支出。