HEALTH LITERACY AND DISCHARGE SAFETY OF HOSPITALIZED SENIORS

描述（由申请人提供）：本职业发展奖的目的是为李·安·林德奎斯特博士，一位接受过奖学金培训的老年医学专家，提供过渡到老年患者安全和健康素养独立研究者的手段和结构。她被任命为西北大学范伯格医学院的医学助理教授，并得到了非常成功的普通内科和老年医学部门强大的研究环境以及她经验丰富的导师的支持。大卫·贝克，琳达·伊曼纽尔和加里·诺斯金。她的长期职业目标是开展和传播以患者为导向的研究，以提高老年人在住院和门诊环境之间过渡时的安全性。在拟议的奖励期间，申请人计划通过健康素养课程、基于理论的患者安全模式、干预实施以及在三级护理医院西北纪念医院的患者安全委员会工作的实际经验，接受健康素养和患者安全方面的重点培训。该研究项目的重点是提高老年人从急性住院过渡回家的安全性。初步研究一致表明，老年人在家庭和医院环境之间移动时缺乏准备并犯多次错误。老年人健康知识不足和记忆力问题的比例也很高，这可能会在出院过程中加剧混乱。以前没有研究将健康素养作为出院安全的潜在风险因素进行评估，也没有将其纳入任何出院干预措施。本项目将分为三个层次：(1)对200名住院老年人进行前瞻性队列调查，并进行家庭随访，以确定健康素养和其他变量对用药错误和错过随访预约的影响。(2)从老年人的角度出发，利用现有的患者安全模式（即失效模式和影响分析[FMEA]和根本原因分析）和老年人焦点小组对出院过程进行系统分析，制定出院安全工具包。(3)利用开发的出院工具包对高危老年人进行试点研究。该应用程序旨在开发与低健康知识和高风险老年人更好地沟通的手段，以使出院系统更安全。通过这一过程，研究者将获得患者安全方面的先进知识，并制定方法来克服卫生知识不足的障碍。在此奖励期结束时，候选人将具备成为健康素养和老年患者安全方面的独立研究者和领导者所需的技能、经验和研究记录。

DESCRIPTION (provided by applicant): The purpose of this Career Development Award is to provide Dr. Lee Ann Lindquist, a fellowship-trained geriatrician, with the means and structure to transition into an independent investigator in Geriatric Patient Safety and Health Literacy. She holds an appointment as Assistant Professor of Medicine at Northwestern University Feinberg School of Medicine and is supported by the strong research environment of the highly successful Divisions of General Internal and Geriatric Medicine as well as the commitment of her experienced mentors, Drs. David Baker, Linda Emmanuel, and Gary Noskin. Her long-term career goal is to conduct and disseminate patient-oriented research that improves the safety of the elderly as they transition between inpatient and outpatient settings. During the proposed award, the applicant plans to receive focused training in health literacy and patient safety through coursework in health literacy, theory based patient safety modalities, interventional implementation, and real world experiences of serving on the patient safety committee at a tertiary care hospital, Northwestern Memorial Hospital. The research project focuses on improving the safety of seniors as they transition home from an acute hospital stay. Preliminary studies consistently show that seniors experience a lack of preparation and make multiple errors as they move between home and hospital settings. Seniors also have high rates of inadequate health literacy and memory issues which can compound the confusion during the discharge process. No studies have previously evaluated health literacy as a potential risk factor for discharge safety nor incorporated it into any discharge interventions. This project will be three tiered: (1) A prospective cohort survey of 200 hospitalized seniors with home follow-up to determine the impact health literacy and other variables have on medication errors and missed follow-up appointments. (2) A systematic analysis of the discharge process from a senior viewpoint using current patient safety modalities (i.e. Failure Modes and Effects Analysis [FMEA] and Root Cause Analysis) and senior focus groups to formulate a discharge safety toolkit. (3) A pilot study using the developed discharge toolkit on high risk seniors. This application aims to develop means of better communicating with low health literate and high risk seniors so as to make the discharge system safer. Through the process, the investigator will obtain advanced knowledge in patient safety and develop methods to overcome the barriers of inadequate health literacy. By the completion of this award period, the candidate will have the skills, experience, and research track record necessary to become an independent investigator and leader in health literacy and geriatric patient safety.