Duke University, Durham, NC.
University of North Carolina-Chapel Hill, Chapel Hill, NC.
J Am Med Dir Assoc. 2019 May;20(5):598-603. doi: 10.1016/j.jamda.2019.01.123. Epub 2019 Feb 28.
To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically diverse countries have launched the WE-THRIVE consortium to develop a common data infrastructure. WE-THRIVE aims to identify measurement domains that are internationally relevant, including in low-, middle-, and high-income countries, prioritize concepts to operationalize domains, and specify a set of data elements to measure concepts that can be used across studies for data sharing and comparisons. This article reports findings from consortium meetings at the 2016 meeting of the Gerontological Society of America and the 2017 meeting of the International Association of Gerontology and Geriatrics, to identify domains and prioritize concepts, following best practices to identify common data elements (CDEs) that were developed through the US National Institutes of Health/National Institute of Nursing Research's CDEs initiative. Four domains were identified, including organizational context, workforce and staffing, person-centered care, and care outcomes. Using a nominal group process, WE-THRIVE prioritized 21 concepts across the 4 domains. Several concepts showed similarity to existing measurement structures, whereas others differed. Conceptual similarity (convergence; eg, concepts in the care outcomes domain of functional level and harm-free care) provides further support of the critical foundational work in LTC measurement endorsed and implemented by regulatory bodies. Different concepts (divergence; eg, concepts in the person-centered care domain of knowing the person and what matters most to the person) highlights current gaps in measurement efforts and is consistent with WE-THRIVE's focus on supporting resilience and thriving for residents, family, and staff. In alignment with the World Health Organization's call for comparative measurement work for health systems change, WE-THRIVE's work to date highlights the benefits of engaging with diverse LTC researchers, including those in low-, middle-, and high-income countries, to develop a measurement infrastructure that integrates the aspirations of person-centered LTC.
为了在国际上支持以患者为中心的长期居住护理，一个由来自 21 个地理和经济上多样化的国家的医学、护理、行为和社会科学研究人员组成的联盟发起了 WE-THRIVE 联盟，以开发一个通用的数据基础设施。WE-THRIVE 的目标是确定具有国际相关性的测量领域，包括在低、中、高收入国家，优先考虑可操作领域的概念，并指定一套数据元素来衡量可以在研究中用于数据共享和比较的概念。本文报告了 2016 年美国老年学学会会议和 2017 年国际老年学和老年医学协会会议上联盟会议的调查结果，以确定领域并确定优先概念，遵循最佳实践确定通过美国国立卫生研究院/国家护理研究所在 CDE 倡议中制定的通用数据元素 (CDE)。确定了包括组织背景、劳动力和人员配置、以患者为中心的护理和护理结果在内的四个领域。通过名义群体过程，WE-THRIVE 在 4 个领域中对 21 个概念进行了优先级排序。一些概念与现有测量结构相似，而另一些则不同。概念上的相似性（趋同；例如，护理结果领域中的功能水平和无伤害护理概念）为监管机构认可和实施的长期护理测量的重要基础工作提供了进一步的支持。不同的概念（发散；例如，以人为本的护理领域中了解患者和对患者最重要的事情的概念）突出了测量工作中的当前差距，与 WE-THRIVE 支持居民、家庭和工作人员的弹性和繁荣的重点一致。与世界卫生组织呼吁进行比较性健康系统变革测量工作一致，WE-THRIVE 的工作迄今为止突出了与来自低、中、高收入国家的不同长期护理研究人员合作的好处，以开发一个集成以人为本的长期护理的愿望的测量基础设施。
