Using Patient Centered Outcomes Research to Examine Consistent Resident Assignmen

本申请表由加州大学伯克利分校教授(终身教授)尼古拉斯·卡塞尔提供 匹兹堡大学卫生政策与管理(HPM)。我的长期职业目标 就是运用我在养老院运营方面的知识来提高住院护理的质量。AS 作为PAR-12-115(K18)的一部分，我制定了与评估益处和危害相关的目标 卫生提供系统干预措施，为决策提供信息，并突出比较 以及对人们来说很重要的结果。这是提供护理服务的重点领域， 为慢性护理患者提供协调。本提案包括以下步骤 为了实现这些目标：1)完成比较研究方法的课程 有效性研究方法；2)指导良好，严格以患者为中心 成果研究(PCOR)；3)参加适当的研究会议、研讨会和 全国性会议；4)限制教学和行政活动。 建议的具体研究是考察护士一致性分配的使用情况 养老院里的助手。一致分配的好处是：它提高了质量 护理，减少工作人员流动率，是工作人员的首选。然而，这些信念是基于 几乎没有经验证据。因此，检查一致分配的影响是重要的， 特别是如果它继续被作为改善护理的一种手段来推广的话。 目前还不确定有多少养老院使用一致分配。关于患者 以结果为中心(PCO)；理论上，护士助理的一致分配被认为 加强工作人员对住院医生护理要求的熟悉程度。因此，改进了 应该是谨慎的结果。然而，没有严格的实证研究来检验两者之间的联系 与PCO保持一致的任务分配。因此，在这项建议中，我将研究(1) 护理员在养老院的一致性分配；(2)护理员的影响 疗养院对PCO的一致性分配；(3)模拟与特定结果相关的结果 要求(和不要求)护士助理一致分配的政策；以及(4)确定(和 分配)促进成功执行和使用一致分配的关键因素。 这些活动将对养老院居民的关爱产生深刻影响。

This application is provided by Nicholas Castle, a professor (tenured) in the Department of Health Policy & Administration (HPM), at the University of Pittsburgh. My long-term career goal is to apply my knowledge of nursing home operations to improve quality of resident care. As part of PAR-12-115 (K18) I have developed goals related to assessing the benefits and harms of health delivery system interventions to inform decision-making and, highlighting comparisons and outcomes that matter to people. This is in the emphasis area of care delivery and coordination for chronic care patients. The following steps are included as part of this proposal to achieve these objectives: 1) completing coursework in research methods in comparative effectiveness research methodology; 2) conducting well-mentored, rigorous patient-centered outcomes research (PCOR); 3) attending appropriate research meetings, seminars, and national conferences; and, 4) limiting teaching and administrative activities. The specific research proposed is to examine the use of consistent assignment of Nurse Aides in nursing homes. Touted benefits of consistent assignment are that: it improves quality of care, reduces staff turnover, and is preferred by staff. However, these beliefs are based on very little empirical evidence. Examining the impact of consistent assignment is thus significant, especially if it continues to be promoted as a means of improving care. It is uncertain how many nursing homes use consistent assignment. With respect to Patient Centered Outcomes (PCO); theoretically, consistent assignment of Nurse Aides is believed to strengthen the familiarity of staff with residents care requirements. As such, improvements in care should result. However, no rigorous empirical studies have examined the association of consistent assignment with PCO. Thus, in this proposal I will examine (1) the extent and level of consistent assignment in nursing homes of Nurse Aides; (2) the influence of Nurse Aide consistent assignment in nursing homes on PCO; (3) simulate outcomes related to specific policies requiring (and not requiring) Nurse Aide consistent assignment; and (4) identify (and distribute) key factors promoting successful implementation and use of consistent assignment. These activities will have a profound influence on the care of residents in nursing homes.