A Data-driven Approach to Improve Nursing Workflow and Patient-centered Care

描述(由申请人提供)：以患者为中心的护理承认患者的愿望、意见和偏好与医疗保健专业人员的愿望、意见和偏好同等重要，并强调需要教育和授权患者在他们的护理中发挥积极作用。以患者为中心的护理的实现与患者和提供者满意度的提高、健康结果的改善和护理交付成本的降低有关(Caffarini，2011；Silow-Carol等人，2006；Wolf等人，2008)。此外，随着健康差距的持续存在，以患者为中心的护理为服务不足的患者提供必要的个性化和量身定制的护理，以实现积极的健康结果。作为比其他人员花费更多时间与患者在一起的提供者，护理人员是提供以患者为中心的护理的核心(De Lucia等人，2009年)。然而，这些一线提供者中的大多数都背负着许多非增值任务，不仅分散了对直接患者护理活动的注意力，还阻碍了他们实施最佳实践的能力，例如用于预防高危患者不良事件(例如跌倒和压疮)的经过验证的护理计划(Hendrich等人，2008年；Storfjell等人，2008年；Aiken等人，2002年)。这类可预防事件的发生尤其令人担忧，因为此类事件的发生不成比例地落在服务不足的人群身上，包括某些种族/族裔社区、说英语的有限个人和老年人(Divi等人，2007年；梅特斯基等人，2011年；罗斯柴尔德等人，2000年)。为了真正实现以患者为中心的护理，医疗保健系统必须引入流程创新，以简化平凡的间接任务，例如为一线护理提供者提供服务文档，并使他们能够有效地采用有利于直接患者护理活动的增值临床实践。在这个项目中，我们将邀请几个合作伙伴-包括一个主要服务于单一语言西班牙语和中文社区的熟练护理设施和一个为退休退伍军人提供长期护理的设施-来实施先进的患者-护士沟通和护士工作流程优化系统。该解决方案将：(I)跟踪个别患者的全面护理计划和相关任务；(Ii)智能地分配和提醒每个提供者其护理计划任务，将未决任务上报给适当的工作人员以加快完成；(Iii)提供任务完成状态和工作流程模式的实时分析，为工作人员和管理人员提供决策支持，以确定可能损害员工生产力或导致不良事件的因素。

DESCRIPTION (provided by applicant): Patient-centered care recognizes patients' desires, opinions, and preferences as equal in importance to those of healthcare professionals, and emphasizes the need to educate and empower patients to play an active role in their care. The achievement of patient-centered care is associated with increased patient and provider satisfaction, improved health outcomes, and reduced cost of care delivery (Caffarini, 2011; Silow-Carol et al., 2006; Wolf et al., 2008). Furthermore, as health disparities continue to persist, patient-centered care offers underserved patients the individualized and tailored care necessary to attain positive health outcomes. As the providers who spend more time with patients than any other personnel, nursing staff are central to the provision of patient-centered care (De Lucia et al., 2009). However, most of these front-line providers are burdened by numerous non-value added tasks that not only distract from direct patient care activities, but also hamper their ability to implement best practices such as proven care plans for preventing adverse events (e.g., falls and pressure ulcers) among at-risk patients (Hendrich et al., 2008; Storfjell et al., 2008; Aiken et al., 2002). The occurrence of such preventable events is especially concerning in light of the fact that such events fall disproportionately on already underserved populations, including certain racial/ethnic communities, limited English speaking individuals, and the elderly (Divi et al., 2007; Metersky et al., 2011; Rothschild et al., 2000). Fr patient-centered care to be truly realized, the healthcare system must introduce process innovations that can streamline mundane, indirect tasks such as service documentation for front-line nursing care providers and enable them to efficiently adopt value added clinical practices that benefit direct patient care activities. In this project, we will engage several partners-including a skilled nursing facility that serves predominantly monolingual Spanish- and Chinese-speaking communities and a long-term care facility for retired veterans-to implement an advanced patient-nurse communication and nurse workflow optimization system. This solution will: (i) track comprehensive care plans and associated tasks for individual patients; (ii intelligently assign and alert each provider of his or her care plan tasks, escalating pending tasks to appropriate staff members to expedite completion; and (iii) offer real-time analysis of task fulfillment status and workflow patterns, providing decision support to both staff and managers for identifying factors that may undermine staff productivity or contribute to adverse events.