Communication Disabilities
Conditions
Brief summary
This multi-methods-multi-site study aims to adapt and evaluate the effects of an implementation support package of strategies to assist primary care clinics in documenting patients' communication disability (CD) and accommodation needs in the electronic health record (EHR) and providing communication accommodations through EHR data extraction, surveys, focus groups, interviews, and clinical practice observations.
Interventions
BEHAVIORALImplementation Support Package
The implementation support package includes materials, activities, and procedures ready for use in diverse primary care practices and will facilitate each clinic's determination of how they will implement collection of disability status and provision of accommodations.
Sponsors
NYU Langone Health
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
EHR Data Extraction 1. Adults 18+ years 2. Patients who had at least one visit within the 21-month EHR data collection period at participating study clinics. Clinic Leadership, Providers \& Clinic Staff 1. Adults 18+ years 2. Individuals of all genders and members of all racial and ethnic categories employed at participating study clinics will be eligible for inclusion. NYULH study personnel will enroll providers and staff referred for study inclusion from all participating study clinics; not just NYULH staff exclusively. Patients 1. Adults 18+ years 2. Patients with communication disabilities seen at least once at participating study clinics during the 21-month study period. 3. Patients who self-identify as proficient in English communication as defined by English being a preferred language, or self-reported ability to participate in an interview in English without the support of an interpreter.
Exclusion criteria
EHR Data Extraction 1. Patients whose records are unavailable due to technical issues. 2. Patients who are not seen at least once at participating study clinics during the 21-month data collection period. 3. Duplicate records (e.g., duplicative EHR records marked for deletion). 4. Patients who have opted-out of research participation. Clinic Leadership, Providers \& Clinic Staff Interviews and Focus Groups 1. Being \<18 years old 2. Not an employed member of a participating study clinic or potential end user of the study implementation strategy. Patient Interviews 1. Being \<18 years old 2. Patients without communication disabilities. 3. Patients with communication disabilities seen outside of participating study clinics. 4. Patients who are unable to provide consent for themselves. 5. Patients who report not being proficient in English communication or self-reported inability to participate in an interview in English without the support of an interpreter.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| (Aim 2) Patient Reach | Baseline, Implementation Follow Up (Approximately Month 9), Maintenance Follow Up (Approximately Month 21) | Percent of patients who have a visit during the time of data collection and have the communication disability field completed in the EHR. A positive outcome for having the communication disability field completed in the EHR will be "no disability" "speech/language disability", "hearing disability", "decline", or "other" documented in the EHR, while a negative outcome will be the CD fields being left blank. All adult patients who are seen in each clinic are eligible to have their disability status documented, regardless of the type of visit. |
| (Aim 3) Adoption | Implementation Follow Up (Approximately Month 9), Maintenance Follow Up (Approximately Month 21) | Adoption assessed for all the patients with a recorded accommodation need; measured as the percentage of clinical encounters in which the accommodation was provided and used, as ascertained through the EHR. |
Countries
United States
Contacts
CONTACTMegan Morris, PhD
CONTACTSankeerth Jinna
PRINCIPAL_INVESTIGATORMegan Morris, PhD
megan.morris@nyulangone.org
Outcome results
None listed