A New Measure of Nursing Home Care Quality

产品说明：（由申请人提供）我们建议完成我们的仪器的改进和现场测试，疗养院护理质量的可观察指标，以便其他研究人员以及潜在的消费者和监管机构可以使用它来评估护理质量。建立在我们的定性研究的初步工作，以确定在养老院的护理质量的维度，我们构建了一个初始的工具，从研究参与者的描述性陈述，可观察到测量每个维度。该工具已被修改了四次，每次在该州的123个养老院进行现场测试，初步的有效性和可靠性测试结果是有希望的。计划进行三个阶段的研究，以完成该仪器的开发，供其他研究人员使用，并评估其效用和心理测量特性作为一种工具，以帮助消费者和监管机构评估养老院的护理质量。在第一阶段，该仪器将在密苏里州的250家疗养院进行现场测试，由经验丰富的医疗保健专业人员建立可靠性和概化理论估计。消费者代表和监管机构将在250家养老院中的30家进行实地测试。将使用最小数据集（MDS）质量指标（Qls）测量同步有效性和已知组分析有效性。在第二阶段，该仪器将在中西部另外两个州的150家养老院进行现场测试。一个两阶段的因素分析使用的数据从400家疗养院将被用来评估仪器的基本结构。在第三阶段，将使用第一阶段和第二阶段的数据根据经验制定评分指南。最后的现场测试计划与消费者谁是决定搬进养老院的可观察指标仪器。鉴于目前的人口和社会趋势，开发一种新的护理质量测量方法，可以在30分钟内轻松管理，并准确可靠地测量质量的复杂维度，这是非常重要的。

DESCRIPTION: (provided by applicant) We propose to complete the refinement and field-testing of our instrument, the Observable Indicators of Nursing Home Care Quality, so that it can be used by other researchers and potentially by consumers and regulators, to assess quality of care on a brief inspection of a nursing home. Building upon our preliminary work of qualitative studies to identify the dimensions of quality of care in nursing homes, we constructed an initial instrument from the descriptive statements from study participants that were observable to measure each dimension. The instrument has been revised four times and field-tested each time in a total of 123 nursing homes in the state; preliminary validity and reliability test results are promising. Three phases of research are planned to complete the development of the instrument for use by other researchers and to assess its utility and psychometric properties as a tool to help consumers and regulators assess nursing home quality of care. During Phase One, the instrument will be field tested in 250 nursing homes in Missouri by experienced health care professionals to establish reliability and Generalizability theory estimates. Field tests with consumer representatives and regulators will be conducted in 30 of the 250 nursing homes. Concurrent validity and known groups analysis validity will be measured using the Minimum Data Set (MDS) quality indicators (Qls). During Phase Two, the instrument will be field tested in 150 nursing homes in two other Midwestern states. A two-stage factor analysis using data from the 400 nursing homes will be used to evaluate the underlying structure of the instrument. During Phase Three, scoring guidelines will be empirically developed using Phase One and Two data. A final field test is planned for the Observable Indicators instrument with consumers who are making the decision to move into a nursing home. In light of current demographic and societal trends, the development of a new measure of quality of care in nursing homes that can be easily administered in under 30 minutes and accurately and reliably measure the complex dimensions of quality is extremely relevant.