PDF(Pubmed)
Abstract：
BACKGROUND: The COVID-19 pandemic added to the decades of evidence that public health institutions are routinely stretched beyond their capacity. Community health workers (CHWs) can be a crucial extension of public health resources to address health inequities, but systems to document CHW efforts are often fragmented and prone to unneeded redundancy, errors, and inefficiency.
OBJECTIVE: We sought to develop a more efficient data collection system for recording the wide range of community-based efforts performed by CHWs.
METHODS: The Communities Organizing to Promote Equity (COPE) project is an initiative to address health disparities across Kansas, in part, through the deployment of CHWs. Our team iteratively designed and refined the features of a novel data collection system for CHWs. Pilot tests with CHWs occurred over several months to ensure that the functionality supported their daily use. Following implementation of the database, procedures were set to sustain the collection of feedback from CHWs, community partners, and organizations with similar systems to continually modify the database to meet the needs of users. A continuous quality improvement process was conducted monthly to evaluate CHW performance; feedback was exchanged at team and individual levels regarding the continuous quality improvement results and opportunities for improvement. Further, a 15-item feedback survey was distributed to all 33 COPE CHWs and supervisors for assessing the feasibility of database features, accessibility, and overall satisfaction.
RESULTS: At launch, the database had 60 active users in 20 counties. Documented client interactions begin with needs assessments (modified versions of the Arizona Self-sufficiency Matrix and PRAPARE [Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences]) and continue with the longitudinal tracking of progress toward goals. A user-specific automated alerts-based dashboard displays clients needing follow-up and upcoming events. The database contains over 55,000 documented encounters across more than 5079 clients. Available resources from over 2500 community organizations have been documented. Survey data indicated that 84% (27/32) of the respondents considered the overall navigation of the database as very easy. The majority of the respondents indicated they were overall very satisfied (14/32, 44%) or satisfied (15/32, 48%) with the database. Open-ended responses indicated the database features, documentation of community organizations and visual confirmation of consent form and data storage on a Health Insurance Portability and Accountability Act-compliant record system, improved client engagement, enrollment processes, and identification of resources.
CONCLUSIONS: Our database extends beyond conventional electronic medical records and provides flexibility for ever-changing needs. The COPE database provides real-world data on CHW accomplishments, thereby improving the uniformity of data collection to enhance monitoring and evaluation. This database can serve as a model for community-based documentation systems and be adapted for use in other community settings.
OBJECTIVE: We sought to develop a more efficient data collection system for recording the wide range of community-based efforts performed by CHWs.
METHODS: The Communities Organizing to Promote Equity (COPE) project is an initiative to address health disparities across Kansas, in part, through the deployment of CHWs. Our team iteratively designed and refined the features of a novel data collection system for CHWs. Pilot tests with CHWs occurred over several months to ensure that the functionality supported their daily use. Following implementation of the database, procedures were set to sustain the collection of feedback from CHWs, community partners, and organizations with similar systems to continually modify the database to meet the needs of users. A continuous quality improvement process was conducted monthly to evaluate CHW performance; feedback was exchanged at team and individual levels regarding the continuous quality improvement results and opportunities for improvement. Further, a 15-item feedback survey was distributed to all 33 COPE CHWs and supervisors for assessing the feasibility of database features, accessibility, and overall satisfaction.
RESULTS: At launch, the database had 60 active users in 20 counties. Documented client interactions begin with needs assessments (modified versions of the Arizona Self-sufficiency Matrix and PRAPARE [Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences]) and continue with the longitudinal tracking of progress toward goals. A user-specific automated alerts-based dashboard displays clients needing follow-up and upcoming events. The database contains over 55,000 documented encounters across more than 5079 clients. Available resources from over 2500 community organizations have been documented. Survey data indicated that 84% (27/32) of the respondents considered the overall navigation of the database as very easy. The majority of the respondents indicated they were overall very satisfied (14/32, 44%) or satisfied (15/32, 48%) with the database. Open-ended responses indicated the database features, documentation of community organizations and visual confirmation of consent form and data storage on a Health Insurance Portability and Accountability Act-compliant record system, improved client engagement, enrollment processes, and identification of resources.
CONCLUSIONS: Our database extends beyond conventional electronic medical records and provides flexibility for ever-changing needs. The COPE database provides real-world data on CHW accomplishments, thereby improving the uniformity of data collection to enhance monitoring and evaluation. This database can serve as a model for community-based documentation systems and be adapted for use in other community settings.
摘要：
背景：COVID-19大流行增加了几十年的证据，表明公共卫生机构经常超出其能力范围。社区卫生工作者（CHW）可以成为解决卫生不平等问题的公共卫生资源的重要扩展。但是记录CHW工作的系统通常是分散的，容易出现不必要的冗余，错误,效率低下。
目的：我们寻求开发一种更有效的数据收集系统，以记录CHW进行的基于社区的广泛工作。
方法：促进公平的社区组织（COPE）项目是一项旨在解决堪萨斯州健康差异的举措，在某种程度上,通过部署CHW。我们的团队反复设计和完善了CHW的新型数据收集系统的功能。使用CHW进行了几个月的试点测试，以确保该功能支持其日常使用。在数据库实现之后，程序被设置为维持CHW的反馈收集，社区合作伙伴,和具有类似系统的组织不断修改数据库以满足用户的需求。每月进行一次持续质量改进过程，以评估CHW绩效；在团队和个人层面交换有关持续质量改进结果和改进机会的反馈。Further,向所有33个COPECHWs和主管分发了15项反馈调查，以评估数据库功能的可行性，可访问性,和总体满意度。
结果：启动时，该数据库在20个县有60个活跃用户。记录的客户互动始于需求评估（亚利桑那州自给自足矩阵和PRAPARE的修改版本[响应和评估患者资产的协议，风险,和经验])，并继续纵向跟踪实现目标的进展。基于用户特定的自动警报的仪表板显示需要跟进和即将发生的事件的客户端。该数据库包含超过5079个客户端的超过55,000个记录的相遇。已记录了来自2500多个社区组织的可用资源。调查数据表明，84%(27/32)的受访者认为数据库的整体导航非常容易。大多数受访者表示他们对数据库总体非常满意（14/32，44％）或满意（15/32，48％）。开放式响应表明了数据库的功能，社区组织的文档和同意书的视觉确认和数据存储在健康保险可移植性和责任法案兼容的记录系统,提高客户参与度，注册过程，和资源的识别。
结论：我们的数据库超越了传统的电子病历，为不断变化的需求提供了灵活性。COPE数据库提供了有关CHW成就的实际数据，从而提高数据收集的一致性，以加强监测和评估。该数据库可以用作基于社区的文档系统的模型，并适用于其他社区环境。
目的：我们寻求开发一种更有效的数据收集系统，以记录CHW进行的基于社区的广泛工作。
方法：促进公平的社区组织（COPE）项目是一项旨在解决堪萨斯州健康差异的举措，在某种程度上,通过部署CHW。我们的团队反复设计和完善了CHW的新型数据收集系统的功能。使用CHW进行了几个月的试点测试，以确保该功能支持其日常使用。在数据库实现之后，程序被设置为维持CHW的反馈收集，社区合作伙伴,和具有类似系统的组织不断修改数据库以满足用户的需求。每月进行一次持续质量改进过程，以评估CHW绩效；在团队和个人层面交换有关持续质量改进结果和改进机会的反馈。Further,向所有33个COPECHWs和主管分发了15项反馈调查，以评估数据库功能的可行性，可访问性,和总体满意度。
结果：启动时，该数据库在20个县有60个活跃用户。记录的客户互动始于需求评估（亚利桑那州自给自足矩阵和PRAPARE的修改版本[响应和评估患者资产的协议，风险,和经验])，并继续纵向跟踪实现目标的进展。基于用户特定的自动警报的仪表板显示需要跟进和即将发生的事件的客户端。该数据库包含超过5079个客户端的超过55,000个记录的相遇。已记录了来自2500多个社区组织的可用资源。调查数据表明，84%(27/32)的受访者认为数据库的整体导航非常容易。大多数受访者表示他们对数据库总体非常满意（14/32，44％）或满意（15/32，48％）。开放式响应表明了数据库的功能，社区组织的文档和同意书的视觉确认和数据存储在健康保险可移植性和责任法案兼容的记录系统,提高客户参与度，注册过程，和资源的识别。
结论：我们的数据库超越了传统的电子病历，为不断变化的需求提供了灵活性。COPE数据库提供了有关CHW成就的实际数据，从而提高数据收集的一致性，以加强监测和评估。该数据库可以用作基于社区的文档系统的模型，并适用于其他社区环境。
