Disseminating a Dashboard for VA Purchased Community Nursing Homes
试验速览
- 阶段
- 不适用
- 入组人数
- 18
- 主要终点
- O/E ratio for CMS Nursing Home Compare Star Ranking for VA-Paid CNH Facilities relative to local market
研究概览
简要总结
Objectives: The purpose of this proposal is to evaluate the impact of the CNH Dashboard implementation on the quality of VA Purchased CNH care relative to other CNH facilities, and to evaluate the quality of Veteran-specific care in purchased CNH facilities by transition and safety outcome measures derived from Veteran-specific CMS data.
Methods: The investigators will evaluate the effect of the CNH Dashboard release in a randomized, stepped-wedge dissemination. This dissemination design allows us to determine the impact of the CNH Dashboard on the quality of purchased CNH facility more systematically than a single phase roll-out. In each of the 4 steps, The investigators will release the CNH Dashboard to a randomly selected set of VISNs. Dashboard release will be accompanied by education.
Findings: The CNH Dashboard has actionable information to leaders in GEC at the local, regional, and national levels.
Impact: When completed, this program will improve the quality of care Veterans receive in VA purchased CNH programs as demonstrated by improved selection of CNH facilities and Veteran-specific measures.
详细描述
Objective: To evaluate the impact of the CNH Dashboard implementation on the quality of contracted CNHs relative to non-contracted CNH in a VAMC Market.
Stepped wedge Dashboard Implementation The investigators propose a stepped wedge implementation of the CNH Dashboard, randomized at the VISN level (n=3-4 per period). The stepped wedge allows for maximization of GEC resources with a systematic roll out to provide sufficient education to every randomized VISN (see education program below). Every 3 months, we will bring a new randomized group of VISNs 'online' with the CNH Dashboard (Table 2). The investigators selected the VISN level as a unit of randomization, because there is integration between VAMCs within a VISN. With approximately 4 VAMCs in each VISN, this release schedule is robust, but manageable with support from this award. The investigators will pilot test the CNH Dashboard in 3 VISNs to finalize the information upload, dashboard, and educational program.
Table 2: Stepped wedge plan for CNH Dashboard roll out Randomized VISN Group Months
-6 to 0 Months 1-3 Months 4-6 Months 7-9 Months 10-12 Pilot VISNs CNH Dashboard CNH Dashboard CNH Dashboard CNH Dashboard CNH Dashboard
- Usual CNH Quality CNH Dashboard CNH Dashboard CNH Dashboard CNH Dashboard
- Usual CNH Quality Usual CNH Quality CNH Dashboard CNH Dashboard CNH Dashboard
- Usual CNH Quality Usual CNH Quality Usual CNH Quality CNH Dashboard CNH Dashboard
- Usual CNH Quality Usual CNH Quality Usual CNH Quality Usual CNH Quality CNH Dashboard
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •No individual patients will be randomized
排除标准
- 未提供
结局指标
主要结局
O/E ratio for CMS Nursing Home Compare Star Ranking for VA-Paid CNH Facilities relative to local market
时间窗: 1 year
We will use the CMS NH Compare Star Ranking for VA-Paid facilities relative to the local market
次要结局
未报告次要终点
研究者
James Rudolph
Director, COIN LTSS
Providence VA Medical Center