Developing a patient inventory to facilitate patient-centered care delivery

描述（由申请人提供）： 背景：VA正在经历一个重大的转变，以改善如何提供护理。这种转变的两个方面是强调以病人为中心的护理，以及使用新的护理模式，增加获得和选择护理服务。为了促进以患者为中心的护理（可能包括通过技术提供的护理）的提供，我们不仅要了解患者的医疗状况，还要了解他或她的背景因素和偏好。该项目涉及开发和测试患者库存，可以补充现有信息（例如，历史和身体），以识别并向患者和提供者提供信息，以支持协作决策制定和以患者为中心的最佳护理交付。 1.识别上下文因素（例如，患者偏好、情境特征、资源），这些因素影响以患者为中心的护理的提供。 a）从患者的角度确定影响以患者为中心的护理的提供的背景因素。 确定提供者认为在提供以患者为中心的护理中重要的患者背景因素。 2.从患者和提供者的角度研究技术在医疗保健提供中的作用。 （a）评估病人使用技术提供护理的经验、资源、意识和意愿。 B）评估提供者对通过技术提供护理的知识和经验。 3.开发和测试患者库存，以促进患者和提供者之间的协作决策，并通过在患者/提供者相遇期间提供上下文信息和偏好来支持以患者为中心的护理。 a）开发一个可以使用iPad或其他设备（例如kiosk）部署的患者库存工具。 B）对退伍军人进行随机试验，以评估当使用患者库存时，是否有更多以患者为中心的护理和协作决策。 我们假设，将患者的上下文信息纳入患者/提供者遇到的护理结果，更以患者为中心，决策是协作的。 作为探索性目标，我们将检查利用患者库存所涉及的工作量流程和时间，以评估这种干预措施的潜在工作流程和成本影响。 研究方法：三个阶段：焦点小组和病人和提供者的访谈，利益相关者的德尔菲小组，病人清单工具与常规护理的随机对照试验。

DESCRIPTION (provided by applicant): Background: VA is undergoing a major transformation to improve how care is delivered. Two aspects of this transformation are an emphasis on patient-centered care, and the use of new models of care that increase access to and choice for care delivery. To facilitate delivery of patient-centered care that may include care delivered through technology, it is important that we understand not only the patient's medical condition but also his or her contextual factors and preferences. This project involves the development and testing of a patient inventory that can complement existing information (e.g., history and physical) to identify and make available to patients and providers information to support collaborative decision making and optimal patient-centered care delivery. 1. To identify contextual factors (e.g., patient preferences, situational characteristics, resources) that influence the delivery of patient-centered care. a) Identify contextual factors that affect delivery of patient-centered care from the patient's perspective. ) Identify patient contextual factors that providers believe are important in delivery of patient- centered care. 2. To examine the role of technology in health care delivery from patient and provider perspectives. a) To assess patients' experiences, resources, awareness of and willingness, to use technology for care delivery. b) To assess providers' knowledge of and experiences with care delivered through technology. 3. To develop and test a patient inventory that facilitates collaborative decision-making between patients and providers, and supports the delivery of patient-centered care by making contextual information and preferences available during the patient/provider encounter. a) To develop a patient inventory tool that can be deployed using an iPad or other device (e.g. kiosk). b) To conduct a randomized trial of Veterans to assess whether there is greater patient- centered care and collaborative decision making when the patient inventory is used. We hypothesize that incorporating patient contextual information into the patient/provider encounter results in care that is more patient-centered and decision making that is collaborative. As an exploratory aim, we will examine workload processes and time involved in utilizing the patient inventory to assess potential workflow and cost impacts of this intervention. Methods: Three phases: focus groups and interviews with patients and providers, Delphi panel with stakeholders, randomized control trial of patient inventory tool v. usual care.