Development of Dashboards to Provide Feedback to Home Care Nurses

 描述(由申请人提供)：该项目建议设计和实施仪表板的可用性评估；这是一种使用可视化技术向临床医生提供性能反馈的健康信息技术形式。2010年，约有1200万人接受了家庭健康机构的护理，这一数字预计将随着美国人口老龄化而增加。接受家庭护理的患者中约有三分之二是通过联邦医疗保险或医疗补助计划提供资金的，这使得医疗保险和医疗补助服务中心(CMS)成为关键的利益相关者，对患者接受的家庭护理服务的质量感兴趣。自2004年以来，CMS一直在报告家庭护理组织的成果指标，假设通过向家庭护理机构提供关于其业绩的反馈，它们将参与质量改进战略。在这项研究中，我们建议重点提供与慢性心力衰竭(CHF)患者护理相关的质量绩效衡量标准的反馈。被诊断为CHF的患者住院的风险增加，这是CMS监测的一个结果，自从CMS开始报告结果指标以来，这一结果没有显著改善。我们建议使用数据可视化技术，通过使用仪表板，向家庭护理护士提供反馈，以便他们可以采取行动改善CHF患者的护理。本研究将开发仪表板技术，使用反馈干预理论指导开发过程，为护士用户提供灵活、动态和个性化的原型。这项研究的具体目的是：1)将与CHF患者管理相关的质量绩效指标付诸实施，这些指标可供个别家庭护理护士用来改进他们的实践。2)向家庭护理护士提供反馈，最大限度地提高他们对数据的理解。3)开发一套灵活的、动态的、个性化的质量仪表板，以满足护士用户的偏好这项研究将使用多种方法来解决这些目标，包括焦点小组、多因素实验研究和可用性评估(包括对护士用户的访谈和调查、启发式评估和任务分析)。多学科研究团队代表了VNSNY家庭护理政策和研究中心与哥伦比亚大学医学中心之间的机构合作，并处于开展这项拟议研究的独特地位。在这项研究中开发的仪表板将是未来研究的重点，评估它们的使用对家庭保健环境中临床医生提供的护理质量的影响。

 DESCRIPTION (provided by applicant): This project proposes to design and carry out a usability evaluation of dashboards; a form of health information technology which use visualization techniques to provide feedback to clinicians on performance. In 2010 approximately 12 million individuals received care from home health agencies, a number that is projected to increase as the US population ages. Around two thirds of patient's receiving home care are funded through Medicare or Medicaid, making the Centers for Medicare & Medicaid Services (CMS) a key stakeholder with an interest in the quality of care home care patients receive. The CMS have been reporting outcome indicators for home care organizations since 2004, with the assumption that through the provision of feedback to home care agencies on their performance, they will engage in quality improvement strategies. In this study we propose to focus providing feedback on quality performance measures related to the care of patients with chronic heart failure (CHF). Patients with a diagnosis of CHF are at an increased risk of hospitalization, which is an outcome monitored by CMS that has not significantly improved since the CMS began reporting outcome metrics. We propose to use data visualization techniques, through the use of dashboards, to provide feedback to home care nurses that they can action to improve the care of patients with CHF. This study will develop the dashboard technology, using Feedback Intervention Theory to guide the development process, to produce a prototype that is flexible, dynamic and individualized to the nurse user. The specific aims of the study are: 1) Operationalize quality performance metrics related to the management of patients with CHF that can be used by individual home care nurses to improve their practice. 2) Provide feedback to home care nurses which maximizes their comprehension of the data. 3) Develop a set of flexible, dynamic quality dashboards individualized to nurse user preferences The study will use a mixture of methods to address these aims including focus groups, a multifactorial experimental study and a usability evaluation (including interviews and surveys with nurse users, heuristic evaluation and task analysis). The multidisciplinary research team represents an institutional collaboration between the VNSNY Center for Home Care Policy and Research and Columbia University Medical Center, and is uniquely positioned to carry out this proposed study. The dashboards developed in this study will be the focus of future research studies evaluating the impact of their use on the quality of care provided by clinicians in home health care settings.