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: 10093367
• 负责人: Gregory L. Alexander
• 金额: $ 14.46万
• 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/10093367
• 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.

摘要 在这份全国养老院质量衡量和信息技术报告中，AHRQ将支持 已经为长期护理环境中的临床研究做出贡献的跨学科研究团队。这个 Pi是一名医生准备的RN，美国护理学院的研究员，有20多年的工作经验 在不同的项目、环境和学科中。其他领导层还包括信息学专家，包括 健康信息技术(IT)、长期护理、调查方法、统计和疗养院 已经召集起来指导这项研究。研究策略包括4轮Delphi技术和30NH IT 专家验证NH IT成熟度调查，该调查包括29个内容领域，包括居民护理、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成熟度分级模型 功能、IT使用范围和IT集成。德尔福专家对NH IT成熟度量表的意见 和阶段性模型将结合起来形成一个新的调查，该调查将用于衡量NH IT成熟度 在全国范围内，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。这项试点研究将在24名受访者中进行，他们参与了 最初的国家NH IT成熟度研究。这些受访者将从223名国民健康保险制度中招募 以不同的总体IT成熟度指标(高、中、低)参与原创研究。 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 在NHS的全国样本中衡量NH IT成熟度的措施研究。方法包括检查 国家信息技术成熟度和成熟阶段之间的关系，以及国家报告和公开提供的国家信息技术成熟度 通过疗养院提供的质量指标连续三年进行比较。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级模型，2) 与NH IT专家一起试行测试NH IT成熟度调查和分级模型，3)使用 在为期3年的国家评估期间进行调查和分级模型，以及4)检查NH IT成熟度是否与 在NHS的全国样本中使用CMS质量措施超过3年。该项目具有很高的创新性；全国性 对NH IT成熟度和成熟度阶段的评估以前没有进行过衡量，也没有与国家 NH质量措施。这项研究包括对全国具有代表性的样本的NH IT成熟度的调查 包括从美国每个州招聘的10%的NHS(N=1,570)。将进行统计分析 使用软件SAS v9(SAS Institute Inc.，Cary，NC，USA)。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 每个州的受访者在分析时都必须考虑到复杂的抽样设计。SAS 将使用SURVEYMEANS、SURVEYFREQ、SURVELOGIC和SURVEYREG等过程 进行这样的分析。