Improving Performance Evaluation of Clinicians to Support National Standards of Practice
改进临床医生的绩效评估以支持国家实践标准
基本信息
- 批准号:10538934
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-01-01 至 2026-12-31
- 项目状态:未结题
- 来源:
- 关键词:AdherenceAgreementAmerican Medical AssociationBenchmarkingBlindedCardiacCardiologyCaringCertificationClinicalClinical assessmentsCollaborationsDataDecentralizationDevelopmentElectronic Health RecordElectronicsEnsureEvaluationFaceFeedbackGoalsHealthcareHospitalsInterventionInterviewInvestigationJointsKnowledgeLicensureLinkMeasurementMeasuresMedicalMedical centerMethodologyMethodsMonitorOnline SystemsOutpatientsPatient CarePatient-Focused OutcomesPeer ReviewPerceptionPerformancePoliciesPositioning AttributeProceduresProcessProfessional PracticeProviderQuality of CareReportingResearchSafetySample SizeSurveysSystemTestingValidity and ReliabilityVeteransWorkcare deliverycase-basedclinical careclinical practicecohortevidence baseimplementation barriersimprovedinnovationinstrumentmedical specialtiesnovelpreventprogramstheoriestooltrustworthinessweb platform
项目摘要
Background: Clinician performance is a critical determinant of high-quality care delivery and patient outcomes.
VA medical centers assess clinicians with Ongoing and Focused Professional Practice Evaluations (OPPE and
FPPE), which require bi-annual chart abstraction by clinicians to assess for adherence to quality measures.
This process is inefficient, lacks evidence of validity or impact, and has been the subject of multiple
investigations by the Office of the Inspector General. VA has therefore committed to establishing national
standards of practice for all clinicians for use in OPPE/FPPE. The Office of Specialty Care has selected a set
of 154 performance indicators across 33 subspecialities. Of these, cardiology is best positioned to test novel
methods for clinician assessment because of existing evidence-based quality measures and established
mechanisms for quality measurement via the Clinical Assessment, Reporting and Tracking (CART) program.
Significance: Two critical knowledge gaps prevent effective performance assessment of cardiology providers in
VA: 1) existing quality measures for general cardiology practice have not been tested for validity and reliability;
and 2) effective case-based peer review methods are unavailable for outpatient cardiology care. Since these
two assessment methods are linked both conceptually and in current VA practice, we propose to test both in a
novel, mixed methods study. Our overall goal is to provide practical tools to assess VA cardiology clinicians
while demonstrating proof-of-concept of this novel paradigm.
Innovation and Impact: These novel assessment methods would free VA clinicians from the burden of low-
value chart abstraction, advance VA’s commitment to be a High Reliability Organization, and improve the
overall quality and safety of Veteran healthcare. In addition, the research will provide generalizable knowledge
to advance the field of clinician performance assessment and improvement.
Specific aims: 1) To assess the reliability and validity of quality measures obtained from electronic health
record data for cardiology clinician assessment; 2) To test the validity of case-based peer review of cardiology
clinician performance; and 3) To identify barriers and facilitators to the use of these assessment methodologies
for OPPE/FPPE in VA practice.
Methodology: This mixed-methods study will build on the evidence-based Clinical Practice Feedback
Intervention Theory and existing methods of quality assessment and peer review for cardiac procedures. In
Aim 1, we will use electronic health record data to assess cardiology clinician performance on 4 indicators that
are currently used for OPPE. Measures will be tested for reliability and validity. A composite measure will be
developed to provide a summary assessment of clinician performance. In Aim 2, we will engage expert
clinicians and other stakeholders to develop and test a web-based platform for blinded, case-based peer
review. We will determine the reliability of peer review assessments and determine the optimal number of
reviews. Finally, we will interview and survey clinicians to determine how these assessment methodologies
may impact clinical care and can be most effectively implemented in practice.
Next Steps/Implementation: This research will develop a trustworthy method for review of clinician
performance that could replace the current inefficient and ineffective OPPE/FPPE process. We will work with
our partners in the Program Offices of Cardiology and Specialty Care to implement in practice.
背景:临床医生的表现是高质量医疗服务和患者预后的关键决定因素。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Jacob A Doll其他文献
Case Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States.
美国早期职业介入心脏病专家的病例量和结果。
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:24
- 作者:
J. Rymer;Dennis I. Narcisse;Angel Chen;D. Wojdyla;Sarah Ashley;Abdulla A. Damluji;Binita Shah;Michael G. Nanna;Rajesh Swaminathan;J. A. Gutierrez;Anezi I Uzendu;A. Nelson;Garrett Bethel;Katherine Kearney;W. S. Jones;Sunil V. Rao;Jacob A Doll - 通讯作者:
Jacob A Doll
Jacob A Doll的其他文献
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{{ truncateString('Jacob A Doll', 18)}}的其他基金
Peer learning to promote quality and appropriate use of percutaneous coronary intervention
同伴学习促进经皮冠状动脉介入治疗的质量和适当使用
- 批准号:
10209959 - 财政年份:2019
- 资助金额:
-- - 项目类别:
Peer learning to promote quality and appropriate use of percutaneous coronary intervention
同伴学习促进经皮冠状动脉介入治疗的质量和适当使用
- 批准号:
10415871 - 财政年份:2019
- 资助金额:
-- - 项目类别:
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