HEALTH LITERACY AND DISCHARGE SAFETY OF HOSPITALIZED SENIORS

描述(由申请人提供)：该职业发展奖的目的是为受过奖学金培训的老年病学家Lee Ann Lindquist博士提供过渡到老年患者安全和健康知识方面的独立调查员的手段和结构。她被任命为西北大学范伯格医学院的医学助理教授，并得到普通内科和老年医学部非常成功的强大研究环境的支持，以及她经验丰富的导师David Baker博士、Linda Emmanuel博士和Gary Noskin博士的承诺。她的长期职业目标是进行和传播以患者为导向的研究，以改善老年人在住院和门诊之间过渡时的安全性。在拟议的奖励期间，申请者计划通过健康素养、基于理论的患者安全模式、干预实施以及在西北纪念医院三级护理医院患者安全委员会服务的真实世界经验等课程工作，接受关于健康素养和患者安全的重点培训。该研究项目的重点是提高老年人从急性住院期间过渡回家的安全性。初步研究一直表明，老年人缺乏准备，在家和医院之间来回走动时会犯下多个错误。老年人的健康素养不足和记忆力问题的比率也很高，这可能会加剧出院过程中的困惑。此前没有研究将健康素养作为出院安全的潜在风险因素进行评估，也没有将其纳入任何出院干预措施。该项目将分为三个层次：(1)对200名住院老年人进行前瞻性队列调查，以确定健康素养和其他变量对用药错误和错过后续预约的影响。(2)使用当前的患者安全模式(即失效模式和影响分析[FMEA]和根本原因分析)和高级焦点小组从高级角度对出院过程进行系统分析，以制定出院安全工具包。(3)使用开发的出院工具包对高危老年人进行的先导性研究。这项应用旨在开发与低健康知识和高危老年人更好地沟通的方法，以使出院系统更安全。通过这一过程，研究人员将获得患者安全方面的先进知识，并开发出克服健康素养不足的障碍的方法。在这一获奖期结束时，候选人将拥有成为健康素养和老年患者安全方面的独立调查员和领导者所需的技能、经验和研究记录。

DESCRIPTION (provided by applicant): The purpose of this Career Development Award is to provide Dr. Lee Ann Lindquist, a fellowship-trained geriatrician, with the means and structure to transition into an independent investigator in Geriatric Patient Safety and Health Literacy. She holds an appointment as Assistant Professor of Medicine at Northwestern University Feinberg School of Medicine and is supported by the strong research environment of the highly successful Divisions of General Internal and Geriatric Medicine as well as the commitment of her experienced mentors, Drs. David Baker, Linda Emmanuel, and Gary Noskin. Her long-term career goal is to conduct and disseminate patient-oriented research that improves the safety of the elderly as they transition between inpatient and outpatient settings. During the proposed award, the applicant plans to receive focused training in health literacy and patient safety through coursework in health literacy, theory based patient safety modalities, interventional implementation, and real world experiences of serving on the patient safety committee at a tertiary care hospital, Northwestern Memorial Hospital. The research project focuses on improving the safety of seniors as they transition home from an acute hospital stay. Preliminary studies consistently show that seniors experience a lack of preparation and make multiple errors as they move between home and hospital settings. Seniors also have high rates of inadequate health literacy and memory issues which can compound the confusion during the discharge process. No studies have previously evaluated health literacy as a potential risk factor for discharge safety nor incorporated it into any discharge interventions. This project will be three tiered: (1) A prospective cohort survey of 200 hospitalized seniors with home follow-up to determine the impact health literacy and other variables have on medication errors and missed follow-up appointments. (2) A systematic analysis of the discharge process from a senior viewpoint using current patient safety modalities (i.e. Failure Modes and Effects Analysis [FMEA] and Root Cause Analysis) and senior focus groups to formulate a discharge safety toolkit. (3) A pilot study using the developed discharge toolkit on high risk seniors. This application aims to develop means of better communicating with low health literate and high risk seniors so as to make the discharge system safer. Through the process, the investigator will obtain advanced knowledge in patient safety and develop methods to overcome the barriers of inadequate health literacy. By the completion of this award period, the candidate will have the skills, experience, and research track record necessary to become an independent investigator and leader in health literacy and geriatric patient safety.