A National Report of Nursing Home Quality Measures and Information Technology

国家疗养院质量措施和信息技术报告

• 批准号: 9554768
• 负责人: Gregory L. Alexander
• 金额: $ 38.82万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9554768
• 关键词: National; Report; Nursing; Home; Quality

Abstract In this National Report of Nursing Home Quality Measures and Information Technology, AHRQ will support an interdisciplinary research team who are already contributing to clinical research in long-term care settings. The PI is a doctorally-prepared RN and fellow in the American Academy of Nursing with over two decades of work in diverse projects, settings, and disciplines. Additional leadership includes experts in informatics including health information technology (IT), long term care, survey methodologies, statistics, and nursing homes have been assembled to guide this study. The research strategy includes a 4 round Delphi Technique with 30 NH IT experts to validate a NH IT Maturity survey that includes 29 content areas in resident care, clinical support, and administrative activities. Delphi experts will help also develop a NH IT maturity staging model based on NH IT capabilities, extent of IT use, and IT integration. Delphi expert opinion regarding the the NH IT Maturity scale and staging model will be combined to form a new survey that will be used to measure NH IT Maturity nationally, in the U.S. The team will conduct a pilot test of the new survey, prior to the national survey, to examine validity of the instrument. The pilot study will be conducted with 24 respondents who participated in the initial national NH IT sophistication study. These respondents will be recruited from a pool of 223 NHs participating in original research with diverse total IT sophistication measures (HIGH, MEDIUM, and LOW). Once the NH IT Maturity survey is validated, the team will conduct a three-wave, longitudinal, repeated measures study measuring NH IT Maturity in a national sample of NHs. Methods include an examination of the relationships between NH IT Maturity and stages of maturity, and nationally-reported, publicly-available NH Quality Measures available through Nursing Home Compare over three consecutive years. Specific aims are: 1) Create a NH IT maturity survey and maturity staging model using a 4 round Delphi with NH IT experts, 2) Pilot test the NH IT Maturity Survey and staging model with NH IT experts, 3) Explore NH IT maturity using the survey and staging model during a 3-year national assessment, and 4) Examine if NH IT maturity is associated with CMS quality measures in a national sample of NHs over 3 years. The project is highly innovative; national assessments of NH IT Maturity and maturity stages have not been measured previously or linked with national NH Quality Measures. This study includes a survey of NH IT Maturity in a nationally representative sample including 10% of NHs recruited from each state in the United States (N=1,570). Statistical analysis will be done using the software SAS v9 (SAS Institute Inc., Cary, NC, USA). Since the sampling method involves stratification by state and since the sampling weights assigned to homes will depend on the number of respondents within each state, the analysis must take the complex sampling design into account. SAS procedures such as SURVEYMEANS, SURVEYFREQ, SURVEYLOGISTIC, and SURVEYREG will be used for such analyses.

抽象的 在这份《国家疗养院质量措施和信息技术报告》中，AHRQ 将支持 跨学科研究团队已经为长期护理机构的临床研究做出了贡献。这 PI 是一名拥有博士学位的注册护士，也是美国护理学院的院士，拥有超过二十年的工作经验 在不同的项目、环境和学科中。其他领导层包括信息学专家，包括 健康信息技术 (IT)、长期护理、调查方法、统计和疗养院 被聚集起来指导这项研究。研究策略包括 4 轮德尔菲技术和 30 NH IT 专家验证了 NH IT 成熟度调查，其中包括住院医师护理、临床支持和医疗服务等 29 个内容领域 行政活动。德尔福专家还将帮助开发基于 NH IT 的 NH IT 成熟度分期模型 能力、IT 使用范围和 IT 集成。德尔福专家关于 NH IT 成熟度量表的意见 和分期模型将合并形成一项新的调查，用于衡量 NH IT 成熟度 在美国全国范围内，该团队将在全国调查之前对新调查进行试点测试，以 检查仪器的有效性。该试点研究将在 24 名参与调查的受访者中进行 最初的国家 NH IT 复杂性研究。这些受访者将从 223 个 NH 中招募 参与具有不同总体 IT 复杂度衡量标准（高、中和低）的原创研究。 一旦 NH IT 成熟度调查得到验证，团队将进行三波、纵向、重复的调查 测量全国 NH 样本中 NH IT 成熟度的研究。方法包括检查 NH IT 成熟度和成熟阶段与国家报告的公开 NH 之间的关系 连续三年通过疗养院比较提供质量衡量标准。具体目标是： 1) 使用 4 轮 Delphi 与 NH IT 专家一起创建 NH IT 成熟度调查和成熟度分期模型，2) 与 NH IT 专家一起对 NH IT 成熟度调查和分期模型进行试点测试，3) 使用 3 年国家评估期间的调查和分期模型，以及 4) 检查 NH IT 成熟度是否相关 在 3 年多的国家 NH 样本中采用 CMS 质量测量。该项目具有很强的创新性；国家的 NH IT 成熟度和成熟度阶段的评估以前尚未测量或与国家相关联 NH 质量措施。本研究包括对全国代表性样本中的 NH IT 成熟度进行调查 包括从美国各州招募的 10% 的 NH（N=1,570）。将进行统计分析 使用软件 SAS v9（SAS Institute Inc.，卡里，北卡罗来纳州，美国）。由于抽样方法涉及 按州分层，因为分配给家庭的抽样权重将取决于家庭的数量 每个州内的受访者，分析必须考虑复杂的抽样设计。 SAS 将使用诸如 SURVEYMEANS、SURVEYFREQ、SURVEYLOGISTIC 和 SURVEYREG 等程序 对于这样的分析。