A protocol for a pragmatic randomized controlled trial using the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) platform approach to promote person-focused primary healthcare for older adults

被引：30

作者：

Dolovich, Lisa ^{[1
]}

Oliver, Doug ^{[1
,2
]}

Lamarche, Larkin ^{[1
]}

Agarwal, Gina ^{[1
,2
]}

Carr, Tracey ^{[1
]}

Chan, David ^{[1
]}

Cleghorn, Laura ^{[1
,3
]}

Griffith, Lauren ^{[4
]}

Javadi, Dena ^{[1
]}

Kastner, Monika ^{[5
]}

Longaphy, Jennifer ^{[1
]}

Mangin, Dee ^{[1
]}

Papaioannou, Alexandra ^{[6
]}

Ploeg, Jenny ^{[3
]}

Raina, Parminder ^{[4
]}

Richardson, Julie ^{[7
]}

Risdon, Cathy ^{[1
,2
]}

Santaguida, P. Lina ^{[4
]}

Straus, Sharon ^{[8
]}

Thabane, Lehana ^{[4
]}

Valaitis, Ruta ^{[3
]}

Price, David ^{[1
,2
]}

机构：

[1] McMaster Univ, David Braley Hlth Sci Ctr, Dept Family Med, 100 Main St West,5th Floor, Hamilton, ON L8P 1H6, Canada

[2] McMaster Family Hlth Team, Hamilton, ON, Canada

[3] McMaster Univ, Sch Nursing, Hamilton, ON L8P 1H6, Canada

[4] McMaster Univ, Clin Epidemiol & Biostat, Hamilton, ON L8P 1H6, Canada

[5] St Michaels Hosp, Li Ka Shing Knowledge Inst, 30 Bond St, Toronto, ON M5B 1W8, Canada

[6] McMaster Univ, Dept Med, Hamilton, ON L8P 1H6, Canada

[7] McMaster Univ, Sch Rehabil Sci, Hamilton, ON L8P 1H6, Canada

[8] Univ Toronto, Inst Hlth Management & Policy, Toronto, ON, Canada

来源：

IMPLEMENTATION SCIENCE | 2016年 / 11卷

关键词：

Primary healthcare; Older adults; Randomized controlled trial; Integrated care; Healthcare volunteers; Interdisciplinary healthcare teams; Implementation; Health services research; Personal health record; GOAL ATTAINMENT; OF-LIFE; REHABILITATION; OUTCOMES; RECORDS; BURDEN; TRANSITIONS; PERFORMANCE; COMPLEXITY; EFFICIENCY;

D O I：

10.1186/s13012-016-0407-5

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Healthcare systems are not well designed to help people maintain or improve their health. They are generally not person-focused or well-coordinated. The objective of this study is to evaluate the effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach in older adults. The overarching hypothesis is that using the Health TAPESTRY approach to achieve better integration of the health and social care systems into a person's life that centers on meeting a person's health goals and needs will result in optimal aging. Methods/design: This is a 12-month delayed intervention pragmatic randomized controlled trial. The study will be performed in Hamilton, Ontario, Canada in the two-site McMaster Family Health Team. Participants will include 316 patients who are 70 years of age or older. Participants will be randomized to the Health TAPESTRY approach or control group. The Health TAPESTRY approach includes intentional, proactive conversations about a person's life and health goals and health risks and then initiation of congruent tailored interventions that support achievement of those goals and addressing of risks through (1) trained volunteers visiting clients in their homes to serve as a link between the primary care team and the client; (2) the use of novel technology including a personal health record from the home to link directly with the primary healthcare team; and (3) improved processes for connections, system navigation, and care delivery among interprofessional primary care teams, community service providers, and informal caregivers. The primary outcome will be the goal attainment scaling score. Secondary outcomes include self-efficacy for managing chronic disease, quality of life, the participant perspective on their own aging, social support, access to health services, comprehensiveness of care, patient empowerment, patient-centeredness, caregiver strain, satisfaction with care, healthcare resource utilization, and cost-effectiveness. Implementation processes will also be evaluated. The main comparative analysis will take place at 6 months. Discussion: Evidence of the individual elements of the Health TAPESTRY platform has been shown in isolation in the previous research. However, this study will better understand how to best integrate them to maximize the system's transformation of person-focused, primary care for older adults.

引用

页数：14

共 90 条

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