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: 9980344
• 负责人: Gregory L. Alexander
• 金额: $ 30.56万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 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/9980344
• 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 在这份有关疗养院质量措施和信息技术的国家报告中，AHRQ将支持 已经在长期护理环境中为临床研究做出贡献的跨学科研究团队。这 PI是一位精心准备的RN，是美国护理学院的研究员，有二十年的工作 在不同的项目，设置和学科中。其他领导包括信息学专家 健康信息技术（IT），长期护理，调查方法，统计和疗养院 被组装以指导这项研究。该研究策略包括一项4轮Delphi技术，并具有30 NH IT 验证NH IT成熟度调查的专家，其中包括29个居民护理中的内容领域，临床支持和 行政活动。 Delphi专家还将帮助开发基于NH IT的NH IT成熟度分期模型 功能，IT使用程度以及IT集成。 Delphi专家关于NH IT成熟度量表的意见 并将组合分期模型以形成一项新调查，该调查将用于测量NH的成熟度 在全国范围内，在美国，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。试点研究将与24名受访者一起进行 最初的国家NH IT复杂研究。这些受访者将从223 NHS的池中招募 参与原始研究，具有多样化的IT复杂度量（高，中和低）。 NH IT成熟度调查得到验证后，团队将进行三波，纵向，重复 衡量NH国家样本中NH成熟度的研究。方法包括检查 NH成熟与成熟阶段之间的关系，以及全国范围内的，公共可用的NH 通过疗养院提供的质量措施将连续三年进行比较。具体目的是： 1）使用与NH IT专家的4轮Delphi创建NH IT成熟度调查和成熟度分期模型，2） 试点测试NH IT成熟度调查和NH IT专家的分期模型，3）使用该NH探索NH IT成熟 在国家评估3年期间的调查和分期模型，以及4）检查是否与NH相关 在3年内，在国家NHS样本中采取了CMS质量措施。该项目具有很高的创新性；国家的 对NH的成熟度和成熟度阶段的评估尚未衡量或与国家联系 NH质量措施。这项研究包括对全国代表性样本中NH IT成熟的调查 包括从美国每个州招募的NHS的10％（n = 1,570）。统计分析将进行 使用软件SAS V9（SAS Institute Inc.，Cary，NC，USA）。由于采样方法涉及 按状态分层以及分配给房屋的采样权重取决于 每个州内的受访者，分析必须考虑复杂的抽样设计。 SAS 将使用诸如监视，调查FREQ，SurveyLogistic和SurveyReg之类的程序 用于此类分析。