随机对照试验的定制审计与反在VHA长期护理设置的随机控制试验
Jennifer Kononowech1, Winifred Scott2, Zach Landis-Lewis3
1Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2800 Plymouth Rd, Ann Arbor, MI, 48109, USA. Jennifer.Kononowech@va.gov.
Implementation science communications
|October 27, 2023
概括
量身定制的反报告没有改善退伍军人卫生管理局长期护理机构的生命维持治疗 (LST) 文档完成率. 附有特定地点提示和国家数据的增强报告显示,与增加的文档没有显著的关联.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 提高质量 提高质量
背景情况:
- 长期护理QUERI计划旨在改善美国退伍军人卫生管理局 (VA) 设置中的维持生命治疗 (LST) 文档.
- 实施涉及社区生活中心 (CLC) 和家庭初级保健 (HBPC) 计划,使用反审计.
- 量身定制的反报告的有效性,包括特定地点的提示和国家数据,尚未得到充分理解.
研究的目的:
- 测试量身定制的反报告,包括特定地点的提示和国家比较数据,对LST文档完成率的影响.
- 将增强的反报告与只有图形和数字数据的原始报告进行比较.
主要方法:
- 进行了一个集群随机对照试验,将定制反报告与标准报告进行比较.
- 调查评估了CLC和HBPC团队成员每季度收到和使用反报告的情况.
- 测量结果是CLC居民在第14天完成LST模板的百分比,第二次访问时HBPC居民的百分比.
主要成果:
- 调查响应率从6.8%到19.3%不等,其中12.8%到25.5%的受访者报告看到反报告.
- 在收到增强反报告和更高的文档完成率之间没有发现显著的关联.
- 报告的更高浏览率与LST模板完成率的增加无关.
结论:
- 提供反的量身定制审计,包括特定地点的提示和国家数据,并没有提高程序层面的LST模板完成率.
- 工作人员报告的比例很低,他们可以查看反,这限制了关于有效性的最终结论.
- 可能需要进一步的研究来确定有效的策略,以改善长期护理机构的LST文档.
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