Development and Validation of the Hospital-to-Home-Health Transition Quality (H3TQ) Index: A Novel Measure to Engage Patients and Home Health Providers in Evaluating Hospital-to-Home Care Transition Quality: A Novel Measure to Engage Patients and Home Health Providers in Evaluating Hospital-to-Home Care Transition Quality.

IF 1.2 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Quality Management in Health Care Pub Date : 2024-07-01 Epub Date: 2024-06-26 DOI:10.1097/QMH.0000000000000419

Alicia I Arbaje, Yea-Jen Hsu, Maningbe Keita, Sylvan Greyson, Jiangxia Wang, Nicole E Werner, Kimberly Carl, Dawn Hohl, Kate Jones, Kathryn H Bowles, Kitty S Chan, Jill A Marsteller, Ayse P Gurses, Bruce Leff

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引用次数: 0

Abstract

Background: Patients requiring skilled home health care (HH) after hospitalization are at high risk of adverse events. Human factors engineering (HFE) approaches can be useful for measure development to optimize hospital-to-home transitions.

Objective: To describe the development, initial psychometric validation, and feasibility of the Hospital-to-Home-Health-Transition Quality (H3TQ) Index to identify patient safety risks.

Methods: Development : A multisite, mixed-methods study at 5 HH agencies in rural and urban sites across the United States. Testing : Prospective H3TQ implementation on older adults' hospital-to-HH transitions. Populations Studied : Older adults and caregivers receiving HH services after hospital discharge, and their HH providers (nurses and rehabilitation therapists).

Results: The H3TQ is a 12-item count of hospital-to-HH transitions best practices for safety that we developed through more than 180 hours of observations and more than 80 hours of interviews. The H3TQ demonstrated feasibility of use, stability, construct validity, and concurrent validity when tested on 75 transitions. The vast majority (70%) of hospital-to-HH transitions had at least one safety issue, and HH providers identified more patient safety threats than did patients/caregivers. The most frequently identified issues were unsafe home environments (32%), medication issues (29%), incomplete information (27%), and patients' lack of general understanding of care plans (27%).

Conclusions: The H3TQ is a novel measure to assess the quality of hospital-to-HH transitions and proactively identify transitions issues. Patients, caregivers, and HH providers offered valuable perspectives and should be included in safety reporting. Study findings can guide the design of interventions to optimize quality during the high-risk hospital-to-HH transition.

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医院到家庭健康过渡质量（H3TQ）指数的开发与验证：让患者和居家医疗服务提供者参与评估医院到居家医疗服务过渡质量的新措施。

背景：住院后需要专业家庭医疗护理（HH）的患者发生不良事件的风险很高。人因工程（HFE）方法可用于制定措施，优化从医院到家庭的过渡：描述医院到家庭健康过渡质量（H3TQ）指数的开发、初步心理测量验证和可行性，以识别患者安全风险：方法：开发：方法：在美国农村和城市的 5 家医疗保健机构开展多站点混合方法研究。测试：在老年人从医院到 HH 的过渡中实施前瞻性 H3TQ。研究人群：出院后接受 HH 服务的老年人和护理人员，以及他们的 HH 提供者（护士和康复治疗师）：H3TQ 是我们通过 180 多个小时的观察和 80 多个小时的访谈开发出来的 12 个项目的医院到 HH 过渡期安全最佳实践。在对 75 个过渡项目进行测试时，H3TQ 证明了使用的可行性、稳定性、结构有效性和并发有效性。绝大多数（70%）从医院到养老院的转院至少存在一个安全问题，而养老院服务提供者发现的患者安全威胁要多于患者/护理人员。最常发现的问题是不安全的家庭环境（32%）、用药问题（29%）、信息不完整（27%）以及患者对护理计划缺乏一般理解（27%）：H3TQ 是一种新颖的测量方法，可用于评估从医院到疗养院的过渡质量并主动识别过渡问题。患者、护理人员和 HH 提供者提供了宝贵的观点，应将其纳入安全报告中。研究结果可指导干预措施的设计，以优化高风险医院到医院过渡期间的质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-

CiteScore

1.90

自引率

8.30%

发文量

108

期刊介绍： Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.