Eliciting Patient Experiences to Augment Public Reports on Health Care Quality

描述(由申请人提供)：该项目创建了第一个科学基础，评估系统地将患者的叙述整合到关于医疗保健提供者的公共报告中的可能性，其中也包括标准化的质量衡量标准。有效整合后，患者账户有可能更有效地传达患者报告的体验，更充分地让消费者参与知情选择，并增强消费者对标准化质量指标的理解。相反，如果患者的评论以目前的形式激增，成为自我报告的部分轶事，它们可能会分散公众对其他更可靠的质量指标的注意力。该项目旨在促进第一种结果，同时减轻第二种结果。拟议的研究建立在先前有限理性研究的基础上，以调查将叙述性患者描述与其他临床医生质量测量相结合的新方法，采用定性、定量和实验方法的组合来：(1)识别和测试几种引出患者/消费者描述的方法，(2)评估激发方法的可靠性和有效性，以捕获所报告的患者体验，以及它们对其他消费者的可信度和价值，(3)将定性报告与基于调查的标准测量(例如CAHPS)进行比较，(4)将定性患者描述纳入公共报告系统的测试方法，并评估其对消费者行为和感知的影响，以及(5)与公共报告赞助商、患者权益倡导者和消费者团体建立关系，以评估在帮助消费者使用整合叙事性和标准化质量衡量标准的报告方面的现实实施机会和挑战。该项目的时间表为三年。第一年将专注于开发可靠的方法来吸引患者账户，这些方法涵盖了与临床医生互动的所有基本方面。在第二年，重点转向探索如何最好地将账户整合到公共报告网站中，以补充消费者对来自患者调查或临床记录的标准化质量指标的理解和使用。在项目的最后一年，议程转向探讨如何最有效地将这项研究的经验教训转化为持续的质量改进和公共报告举措。该项目将由一个跨学科团队推进，并由一个由社区联盟、患者倡导项目和代表消费者的组织的代表组成的顾问委员会提供指导。

DESCRIPTION (provided by applicant): This project creates the first scientific foundation assessing the potential for systematically integrating patients' narrative accounts into public reports on health care providers that also include standardized quality measures. Effectively integrated, patients' accounts hold the potential to more effectively convey patient- reported experience, more fully engage consumers in informed choices, and enhance consumers' understanding of standardized quality metrics. Conversely, if patient comments proliferate in their current form as self-reported, partial anecdotes, they threaten to distract public attention from other more reliable quality measures. This project is intended to foster the first set of outcomes while mitigating the second. The proposed research builds on insights from previous studies of bounded rationality to investigate new ways of integrating narrative patient accounts with other measures of clinician quality, employing a mix of qualitative, quantitative, and experimental methods to: (1) identify and test several methods of eliciting patient/consumer accounts, (2) evaluate elicitation methods for their reliability and validity capturing reported patient experiences, as well as their trustworthiness and value to other consumers, (3) compare qualitative reports with standard survey-based measures (e.g. CAHPS), (4) test methods for incorporating qualitative patient accounts into public reporting systems, and assess their impact on consumer behavior and perceptions, and (5) establish relationships with public report sponsors, patient advocates and consumer groups to assess real-world implementation opportunities and challenges in assisting consumers to use reports that integrate narrative and standardized measures of quality. The project has a three year time-line. The first year will focus on developing reliable methods of eliciting patient accounts that capture all essential facets of interactions with clinicians. In the second year the focus shifts to exploring how best t integrate accounts into public reporting websites in ways that complement consumers' understanding and use of standardized quality metric derived from patient surveys or clinical records. In the final year of the project, the agenda shifts to exploring how to most effectively translate the lessons from this research to ongoing quality improvement and public reporting initiatives. The project will be pursued by an interdisciplinary team, with guidance from an advisory board composed of representatives from community coalitions, patient advocacy programs and organizations representing consumers.