Detecting and Understanding Disparities in Pediatric Safety Events for Hospitalized Children

检测和了解住院儿童儿科安全事件的差异

• 批准号: 10450528
• 负责人: Kavita Parikh
• 金额: $ 4.25万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-07 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10450528
• 关键词: Detecting; Understanding; Disparities; Pediatric; Safety

Project Summary/Abstract: Despite decades of focus on reducing medical errors, children continue to suffer substantial harms in hospital settings, and pediatric safety events in hospitals disproportionately affect children of color and those who live in poverty. While there has been work in pediatrics to categorize and address safety events, there is a critical need in our understanding and approaches to eliminate racialized and socio- economic disparities in pediatric safety events. The long-term goal is to ensure equitable care for all hospitalized children. The overall objectives are to leverage existing pediatric safety measures to detect and understand drivers of disparities in select inpatient pediatric safety events. The Chin framework for advancing health equity in patient safety, which is informed by patient and family engagement, will be used, and consists of identifying health disparities, understanding potential mechanisms that drive them, and then designing interventions to eliminate disparities. In direct response to Agency for Healthcare Research and Quality’s (AHRQ) recently released Special Emphasis Notice “Interest in Health Services Research to Advance Health Equity” NOT-HS-21-041, a mixed-methods study to advance the nation’s goal of achieving equity in the delivery of healthcare services by reducing disparities in select pediatric patient safety events is proposed through these two specific aims: 1). Detect disparities in pediatric safety events among hospitalized children by race/ethnicity and/or socioeconomic status. Pediatric safety outcomes will include the AHRQ pediatric quality indicators (PDIs) and adverse medical device event (AMDE) rates in pediatric hospitalizations. Both the Kids’ Inpatient Database and Inpatient Essentials database will be evaluated for disparities in PDIs or ADMEs. 2). Understand mechanisms and identify potential interventions for eliminating racialized and socio-economic disparities in pediatric safety events. Selected pediatric safety events will be identified and in-depth, qualitative analysis via focus groups of hospital staff/clinicians and patients/families will be conducted to identify potential mechanisms of disparities and interventions to address these disparities. This aim will be informed by Flores and Ngui’s comprehensive, patient-and-family centered framework for understanding disparities in pediatric safety events. The research proposed in this application is innovative because the disparities in pediatric safety events will be analyzed using established measures of pediatric safety combined with patient/family engagement to comprehensively understand potential drivers of selected measures. The proposed research is significant because it is expected to provide a more detailed understanding of select disparities in pediatric safety events and identification of potential interventions to address these disparities. These results are expected to have profound positive impact by identifying patient-family centered candidate interventions for addressing specific disparities in pediatric safety for future R01 study. This proposal aligns with AHRQ’s goals and priority population of improving health care quality, safety, and equity in children.

项目摘要/摘要：尽管几十年来一直致力于减少医疗错误，但儿童仍然遭受痛苦 医院环境中的重大伤害，医院中的儿科安全事件对儿童的影响尤为严重 有色人种和生活贫困的人。虽然儿科方面已经开展了分类和解决的工作 安全事件中，我们迫切需要了解并采取措施消除种族歧视和社会歧视 儿科安全事件的经济差异。长期目标是确保所有人得到公平的照顾 住院的儿童。总体目标是利用现有的儿科安全措施来检测和 了解特定住院儿科安全事件中差异的驱动因素。钦的推进框架 将使用患者安全中的健康公平，由患者和家庭参与告知，包括 识别健康差异，了解驱动这些差异的潜在机制，然后设计 采取干预措施消除差距。直接回应医疗保健研究和质量局的 （AHRQ）最近发布了特别强调通知“对健康服务研究的兴趣以促进健康 公平”NOT-HS-21-041，一项混合方法研究，旨在推进国家实现公平的目标 建议通过减少特定儿科患者安全事件中的差异来提供医疗保健服务 通过这两个具体目标：1）。检测住院儿童安全事件中的差异 按种族/民族和/或社会经济地位分类的儿童。儿科安全结果将包括 AHRQ 儿科住院的儿科质量指标（PDI）和不良医疗器械事件（AMDE）率。 将评估儿童住院数据库和住院必需品数据库的 PDI 差异或 ADME。 2）。了解机制并确定消除种族歧视和歧视的潜在干预措施 儿科安全事件的社会经济差异。将确定选定的儿科安全事件并 将通过医院工作人员/临床医生和患者/家属焦点小组进行深入的定性分析 确定潜在的差异机制以及解决这些差异的干预措施。这个目标将是 遵循弗洛雷斯和恩吉的全面的、以患者和家庭为中心的理解框架 儿科安全事件的差异。本申请中提出的研究具有创新性，因为 将使用既定的儿科安全措施结合儿科安全事件的差异进行分析 通过患者/家属的参与，全面了解所选措施的潜在驱动因素。这 拟议的研究意义重大，因为它有望提供对选择的更详细的理解 儿科安全事件的差异以及确定解决这些差异的潜在干预措施。 通过确定以患者家庭为中心的候选人，这些结果预计将产生深远的积极影响 为解决未来 R01 研究中儿科安全性的具体差异而采取的干预措施。该提案符合 AHRQ 的目标和优先人群是改善儿童的医疗保健质量、安全和公平。