Person-centered quality measurement and management in a system for addictions treatment in New York State
纽约州成瘾治疗系统中以人为本的质量测量和管理
基本信息
- 批准号:10772463
- 负责人:
- 金额:$ 241.89万
- 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:2023-09-30 至 2028-08-31
- 项目状态:未结题
- 来源:
- 关键词:AccountabilityAccountingAddressAdoptionAdverse eventAmbulatory Care FacilitiesAutomobile DrivingBlack PopulationsCaringCessation of lifeCharacteristicsClientClinicClinicalCollaborationsCommunitiesConsultContractsDataData AnalysesDevelopmentDrug Metabolic DetoxicationDrug userEffectivenessElectronic Health RecordElementsEnsureEquityEventEvidence based practiceFamilyFeedbackFundingGoalsGovernmentHarm ReductionHealthHealthcareHospitalizationIndividualInsurance CarriersInterventionInterviewInvestmentsLatinx populationLeadershipMeasurementMeasuresMediationMedicaidMethodsMonitorNew YorkOpioidOutcomeOverdosePatient-Focused OutcomesPatientsPerceptionPerformancePharmaceutical PreparationsPoliciesProcessProfessional counselorPropertyPsychometricsQualitative MethodsQuality of CareQuestionnairesRecording of previous eventsRegistriesReportingResearchResistanceRisk AdjustmentScienceServicesStatistical MethodsSubstance Use DisorderSurveysSystemTechnologyTestingUniversitiesValidationVariantVital StatisticsWorkaddictioncare systemsdata literacyeffectiveness testingevidence basehealth inequalitiesimprovedmedication for opioid use disordermortalitynovel strategiesopioid epidemicopioid use disorderoverdose deathperson centeredresponsesocial vulnerabilitysubstance use treatmentsynthetic opioidtooltreatment centertreatment servicesuser centered design
项目摘要
Project Summary
In 2021, the number of drug overdoses in New York continued to rise, with 4,946 deaths involving opioids.
Synthetic opioids are driving the rise as these are mixed with other substances taken by people who use drugs
(PWUD). Alarmingly, the rates of overdose deaths are rising faster for Black and Latinx individuals,
exacerbating health inequities. The New York State agency that regulates addictions treatment—the Office of
Addiction Services and Supports (OASAS)—oversees a system that annually serves 350,000 individuals with
substance use disorders (SUD). Within the system, outpatient clinics provide the majority of treatment services
for individuals with opioid use disorders (OUD). In response to the continuing opioid crisis, OASAS is calling for
new approaches that embrace person-centered care, evidence-based practices, equitable treatment, and harm
reduction principles. OASAS envisions a revised treatment system that better retains clients in treatment,
mitigates adverse healthcare events, and reduces deaths. To drive change, OASAS will invest in a quality
measurement and management (QM2) strategy that provides performance feedback to activate leadership
and staff of clinics to improve practice as well as publicizes quality measures to ensure public accountability.
Using the Donabedian framework as a guide, the OASAS QM2 strategy will include a suite of structural (e.g.,
client/counselor ratios), process (e.g., use of medications for OUD), and outcome (e.g., hospitalization for
detoxification) quality measures. In support of the strategy, OASAS will also provide funding to ensure all
clinics have electronic health records (EHR) that have capacity to capture and report on quality measures. The
OASAS strategy will address common barriers to QM2 efforts, including: inadequate technological capacity at
clinics, dearth of validated quality measures for SUD treatment, limited data literacy in the workforce,
insufficient expertise in change management among staff, and clinic leadership resistance due to concerns
about fairness in accounting for the clinical complexity of their clients. In addition, OASAS recognizes that
gathering data directly from patients is essential to assessing whether their goals and needs are addressed in
a person-centered system of care. OASAS will work with academic partners to develop measures and provide
support to clinics to address these barriers. This QM2 research center (QM2-RC) proposal comes from an
academic-government partnership that has a longstanding history of collaborating on studies to improve
treatment for SUD. The broad aim is to build then test a science-based QM2 strategy for person-centered
treatment. The project will leverage OASAS's investment in its new QM2 strategy and policy leadership. The
academic partners will offer expertise in statistical methods for measurement validation, risk adjustment, and
causal inference that will address some obstacles to QM2 as well as build the evidence base for the benefits of
the strategy. The team will also assess how clinics and other stakeholders—e.g., patients, payers—incorporate
the QM2 strategy into practice improvement, contract negotiations, and choosing clinics.
项目总结
项目成果
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