Implementation of Communication Disability Collection and Accommodations in Primary Care Settings

在初级保健机构中实施沟通障碍收集和住宿

• 批准号: 10705832
• 负责人: Megan A Morris
• 金额: $ 76.69万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-16 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705832
• 关键词: Academy; Address; Adoption; Adult; Adverse event; Advocate; Affect; Americans with Disabilities Act; Appointment; Arthritis; Asthma; Caring; Characteristics; Chicago; Chronic; Clinic; Clinical; Collection; Colorado; Communication; Communication Board; Communication Disability; Communities; Data; Diabetes Mellitus; Disabled Persons; Disparity; Documentation; Educational Intervention; Elderly; Electronic Health Record; Ensure; Equitable healthcare; Equity; Ethnic Origin; Event; Gender Identity; Goals; Health; Health system; Healthcare; Healthcare Systems; Hearing; Hearing Aids; Hospitalization; Hybrids; Hypertension; Individual; Infant Mortality; Inpatients; Intake; Intervention; Justice; Language; Language Disorders; Learning; Literature; Maps; Maternal Mortality; Medical; Medical History; Medicine; Methods; Outcome; Patient Care; Patients; Persons; Policy Maker; Population; Practical Robust Implementation and Sustainability Model; Process; Provider; Quality of Care; Race; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reporting; Research; Rural; Sex Orientation; Social support; Source; Speech; Testing; United States; Visit; Voice; Woman; Women' s Health; Work; care outcomes; demographics; design; disability; effectiveness/implementation trial; evidence base; experience; federal policy; health care availability; health care disparity; health care service; health care service organization; health care settings; health data; health disparity; health equity promotion; health information technology; implementation evaluation; implementation outcomes; implementation strategy; marginalized population; patient oriented; patient portal; primary care clinic; primary care practice; primary care setting; primary outcome; programs; safety net; social; social health determinants; willingness

PROJECT SUMMARY/ABSTRACT The Americans with Disability Act (ADA) requires that healthcare organizations and providers ensure that patients with disabilities receive equal access to healthcare services, facilities and programs. While the ADA was passed more than 30 years ago, research demonstrates that persons with disabilities continue to experience significant health and healthcare disparities. Persons with communication disabilities, who represent >14% of the US population, experience specific challenges to patient-centered communication, an essential component of high-quality care as outlined by the National Academy of Medicine report “Crossing the Quality Chasm”. Documentation of patients’ demographic information (e.g., race/ethnicity, sexual orientation, and gender identity) and social data (e.g., Social Determinants of Health) in electronic health records (EHR) has been recognized by healthcare organizations, policy makers and advocates as a necessary step towards advancing healthcare equity. Unfortunately, most healthcare organizations do not consistently or comprehensively document patients’ disability status within the EHR. Consistent and accurate documentation of disability status is needed to track the quality of care delivered to patients with communication disabilities and to identify patients who need disability accommodations required by the ADA. This project aims to adapt and evaluate the effects of an implementation support package of strategies to assist primary care clinics in (1) documenting patients’ communication disability and accommodation needs in the EHR and (2) providing communication disability accommodations. In Aim 1 we will employ Implementation Mapping Adapt, which will allow us to review existing literature and build upon what is already known about implementation of documentation of other demographic data. With a stakeholder panel, we will adapt an implementation support package for documentation of communication disability status and provision of communication accommodations in the primary care setting. Our final product will be a multi-component, multi- level implementation support package designed for use in varying contexts. In Aim 2 and 3, we will conduct a multi-method, Hybrid Type III effectiveness-implementation trial across 9 clinics in 3 healthcare systems: UCHealth, Denver Health (a safety net health system), and Northwestern Medicine in Chicago, IL. The primary care clinics will be diverse (e.g., urban, rural, women’s health, and geriatric clinics) to maximize learnings across different contexts. Our outcomes will be guided by the PRISM/RE-AIM framework, with our primary outcomes being the Reach of documentation of patients’ disability status (Aim 2) and the Adoption of provision of disability accommodations (Aim 3.) The study findings will inform a support package with scalable strategies that can be adapted and generalized to other types of disabilities.

项目总结/文摘