PA-20-070: The PIPA (Pediatric Inpatient Pathways for Asthma) Study: Optimizing Quality of Hospital Care for Children with Asthma

项目摘要/摘要 新冠肺炎疫情已迫使美国的医疗保健服务迅速发生变化。 包括对住院儿童的护理。这些变化(例如，减少非紧急医疗保健 在新冠肺炎案例中保持供应和应对激增的能力)产生了各种影响 在护理、质量和安全方面。我们建议从这些变化中找出主要的教训 照顾住院儿童，并了解 这些变化；这些知识可以用来在现在或未来提高护理质量 流行病或灾难。Kaiser博士是正在进行的职业发展奖的PI，该奖项由 AHRQ。在此次颁奖期间，她带领全国医院质量协作体工作 改善住院儿科护理。2、3为了这笔补助金，我们从25名领导中招募了 这些医院中的一家参与了定性研究。我们的具体目标是确定主要的 从新冠肺炎大流行期间医疗服务提供的变化中吸取教训 了解住院儿童的潜在质量和安全影响。我们会 进行有目的的抽样。我们将从25个站点中的每个站点招募2-3名参与者(总计 N=50-60名参与者)，包括医疗保健提供计划的负责人(例如，住院儿科 单位主任)和额外的一线临床医生。我们开发了一种半结构化的 使用医院灾难恢复框架和“卫生系统应对措施”的访谈指南 致新冠肺炎：快速周期评估的优先事项，由Academy emyHealth撰写。我们将进行一次调查- 使用恒定比较方法进行深度定性分析，以开发概念模型 新冠肺炎大流行期间医疗保健提供方面的重大变化和经验教训。我们会 还探讨了：1)对弱势儿童群体的潜在不同影响，以及2)潜在影响 质量和安全方面的影响。我们的预期结果是对 COVID期间住院儿童医疗保健服务的主要变化和教训- 19大流行病，确定对护理质量和安全的潜在影响，以及选择 未来量化分析新冠肺炎影响的候选质量指标 在住院儿童中的大流行。我们的发现可以通过以下途径迅速广泛传播 我们的组织合作伙伴，以更好地使医院能够改善和监测 孩子们。

PROJECT SUMMARY/ABSTRACT The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the US, including the care of hospitalized children. These changes (e.g., reducing non-urgent healthcare to maintain supplies and capacity for surges in COVID-19 cases) have had a variety of impacts on care quality and safety. We propose to identify major learnings from these changes in the care of hospitalized children and understand the intended and unintended consequences of these changes; this knowledge can be used to improve care quality during this or future pandemics or disasters. Dr. Kaiser is PI of an ongoing career development award funded by AHRQ. During this award, she led a national quality collaborative of 89 hospitals working to improve inpatient pediatric care.2,3 For this grant supplement, we have recruited leaders from 25 of these hospitals to participate in a qualitative study. Our specific aim is to identify major learnings from healthcare delivery changes during the COVID-19 pandemic and understand the potential quality and safety implications for hospitalized children. We will conduct purposeful sampling. We will recruit 2-3 participants from each of the 25 sites (total n=50-60 participants), including leaders of healthcare delivery planning (e.g., inpatient pediatric unit directors) and additional front-line clinicians. We have developed a semi-structured interview guide using the Hospital Disaster Resilience framework and “Health Systems Respond to COVID-19: Priorities for Rapid-Cycle Evaluation” by AcademyHealth. We will conduct an in- depth qualitative analysis using constant comparative methods to develop a conceptual model of major changes and learnings in healthcare delivery during the COVID-19 pandemic. We will also explore: 1) potential disparate effects on vulnerable groups of children, and 2) potential quality and safety implications. Our expected outcomes are an in-depth understanding of major changes and learnings in healthcare delivery for hospitalized children during the COVID- 19 pandemic, identification of potential implications for quality and safety of care, and selection of candidate quality metrics for future quantitative analyses of the impacts of COVID-19 pandemic on hospitalized children. Our findings can be rapidly and widely disseminated through our organizational partners to better enable hospitals to improve and monitor care quality for children.