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
基本信息
- 批准号:10586694
- 负责人:
- 金额:$ 80.16万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 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:
- 关键词:AcademyAddressAdoptionAdultAdverse eventAdvocateAffectAmericans with Disabilities ActAppointmentArthritisAsthmaCaringCharacteristicsChicagoChronicClinicClinicalCollectionColoradoCommunicationCommunication BoardCommunication DisabilityCommunitiesDataDiabetes MellitusDisabled PersonsDocumentationEducational InterventionElderlyElectronic Health RecordEnsureEthnic OriginEventFoundationsGender IdentityGoalsHealthHealth PersonnelHealth systemHealthcareHealthcare SystemsHearingHearing AidsHybridsHypertensionIndividualInfant MortalityInpatientsIntakeInterventionJusticeLanguageLanguage DisordersLearningLiteratureMaternal MortalityMedicalMedical HistoryMedicineMethodsOutcomePatientsPersonsPolicy MakerPopulationPractical Robust Implementation and Sustainability ModelPrimary Health CareProcessQuality of CareRaceReach Effectiveness Adoption Implementation and MaintenanceReportingResearchRuralSex OrientationSocial supportSourceSpeechTestingTimeUnited StatesVisitVoiceWomanWomen&aposs HealthWorkcare outcomesdemographicsdesigndisabilityeffectiveness implementation trialevidence baseexperiencefederal policyhealth care availabilityhealth care disparityhealth care servicehealth care service organizationhealth care settingshealth datahealth disparityhealth information technologyimplementation evaluationimplementation outcomesimplementation strategymarginalized populationpatient orientedpatient portalprimary care settingprimary outcomeprogramssafety netsocialsocial health determinantswillingness
项目摘要
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.
项目摘要/摘要
《美国残疾人法案》(ADA)要求医疗保健组织和提供者确保
残疾患者可以平等地获得医疗服务、设施和方案。虽然美国反兴奋剂机构
是在30多年前通过的,研究表明残疾人继续
体验显著的健康和医疗保健差异。有沟通障碍的人,
代表着14%的美国人口,经历了以患者为中心的沟通的具体挑战,以及
高质量护理的基本组成部分,如美国国家医学研究院报告《跨越
质量鸿沟“。
记录患者的人口统计信息(例如,种族/民族、性取向和性别
电子健康记录(EHR)中的身份)和社会数据(例如,健康的社会决定因素)
医疗保健组织、政策制定者和倡导者认为这是推进
医疗保健股权。不幸的是,大多数医疗机构没有始终如一地或全面地
在电子病历中记录患者的残疾状况。一致和准确的残疾状况记录
需要跟踪向有沟通障碍的患者提供的护理质量并确定
需要美国残疾人协会要求的残疾住宿的患者。
该项目旨在调整和评估执行一揽子战略支助的效果,以
协助初级保健诊所(1)记录患者的沟通障碍和住宿需求
电子病历和(2)提供沟通障碍设施。在目标1中,我们将采用实施
地图调整,这将使我们能够回顾现有的文献并在已知的基础上进行改进
实施其他人口统计数据的文件编制。通过利益相关者小组,我们将调整
用于记录通信残疾状况的执行支助包和提供
初级保健环境中的沟通便利。我们的最终产品将是一个多组件,多-
为在不同环境中使用而设计的级别实施支持包。在目标2和目标3中,我们将进行
多方法、混合型III有效性--在3个医疗保健系统的9个诊所进行实施试验:
加州大学健康分校、丹佛健康(一个安全网医疗系统)和伊利诺伊州芝加哥的西北医学。初级阶段
护理诊所将是多样化的(例如,城市、农村、妇女保健和老年诊所),以最大限度地提高学习能力
跨越不同的环境。我们的成果将以PRISM/RE-AIM框架为指导,我们的主要
结果是记录患者残疾状况的范围(目标2)和采用规定
残疾人士住宿(目标3)研究结果将为支持方案提供可扩展的战略
这可以适应和推广到其他类型的残疾。
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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Megan A Morris其他文献
Trust and activation in defining patient-clinician interactions for chronic disease management.
定义慢性病管理的患者与临床医生互动的信任和激活。
- DOI:
- 发表时间:
2022 - 期刊:
- 影响因子:3.5
- 作者:
Grace E. Venechuk;L. Allen;J. Thompson;Megan A Morris;D. Matlock;C. McIlvennan;Neal W. Dickert;C. Tietbohl - 通讯作者:
C. Tietbohl
Silence in the EHR: infrequent documentation of aphonia in the electronic health record
- DOI:
10.1186/1472-6963-14-425 - 发表时间:
2014-09-23 - 期刊:
- 影响因子:3.000
- 作者:
Megan A Morris;Abel N Kho - 通讯作者:
Abel N Kho
Megan A Morris的其他文献
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{{ truncateString('Megan A Morris', 18)}}的其他基金
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 - 财政年份:2022
- 资助金额:
$ 80.16万 - 项目类别:
Disparities in Patient-Centered Communication Experienced by Patients with Communication Disabilities
有沟通障碍的患者在以患者为中心的沟通中所经历的差异
- 批准号:
10393171 - 财政年份:2018
- 资助金额:
$ 80.16万 - 项目类别:
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