Leveraging Human Factors to Evaluate Quality of Neonatal Delivery Room Care

项目摘要/摘要 本次指导临床科学家研究职业发展奖(K08)的目的是为 海蒂·M·赫里克，医学博士，儿童医院临床讲师兼主治医生 费城和宾夕法尼亚大学医院为她成为一名 具有人的因素(HF)专业知识的独立卫生服务研究科学家及其在 新生儿复苏。她的长期职业目标是将HF方法学应用于新生儿复苏 改善提供者的复苏表现和新生儿结局。她的近期目标是获得 成功竞争R01拨款所需的指导、培训和研究经验，旨在 优化新生儿复苏以减少DR实践和结果的差异。为了实现这些目标 并过渡到独立，Herrick博士和她的导师们已经发展了一个全面的职业生涯 基于以下内容的发展计划：(1)来自她与之有可靠合作伙伴的团队的密集指导 合作和学术方面的记录；(2)复杂系统的高频高级培训，质量指标 发展和定性方法；(3)有指导的领导职位；(4)创新研究 计划使用HF框架来定义和验证灾难恢复质量指标，并制定全面的灾难恢复 评估影响质量的因素的模型。 早产是一个重大的临床问题，具有巨大的社会负担和成本，十分之一的人会受到影响。 在美国送货。DR复苏对极早产儿的存活至关重要。 不幸的是，美国国内的DR实践和结果存在显著差异。这个变种 强调需要改进和始终如一的护理。不幸的是，没有全面的 评估灾难恢复服务的方法，并且没有经过验证的灾难恢复质量指标来帮助解释和纠正这一问题 变种。在一项多中心研究中利用HF方法，Herrick博士的研究提案将填补这一空白 知识差距通过(1)对DR复苏进行深入的Works系统分析，以确定 影响过程和结果差异的系统性因素，(2)确定和细化灾难恢复质量指标 使用改进的德尔菲法，以及(3)检验共识质量度量的信度和有效性。 Herrick博士的K08研究将解决缺乏DR质量指标的关键差距。这些研究的结果 研究将直接通知未来旨在减少变异以优化新生儿的R01提案 复苏。她的职业发展计划勾勒出了一条获得知识、技能和经验的明确途径 需要作为一名卫生服务研究科学家获得独立，并成为应用程序的领导者 人为因素对新生儿复苏的影响。

PROJECT SUMMARY/ABSTRACT The purpose of this Mentored Clinical Scientist Research Career Development Award (K08) is to prepare Heidi M. Herrick, MD MSCE, Clinical Instructor and Attending Physician at the Children’s Hospital of Philadelphia and the Hospital of the University of Pennsylvania for her long-term goal of becoming an independent health services research scientist with expertise in Human Factors (HF) and its application to neonatal resuscitation. Her long-term career objective is to apply HF methodology to neonatal resuscitation to improve provider resuscitation performance and neonatal outcomes. Her immediate goal is to acquire the mentorship, training, and research experience needed to successfully compete for R01 grants aimed at optimizing neonatal resuscitation to decrease variation in DR practices and outcomes. To achieve these goals and transition to independence, Dr. Herrick and her mentors have developed a comprehensive career development plan based on the following: (1) intensive mentorship from a team with whom she has a proven track record of collaboration and scholarship; (2) advanced training in HF in complex systems, quality metric development, and qualitative methodology; (3) mentored leadership positions, and (4) an innovative research plan to use a HF framework to define and validate DR quality metrics and to develop comprehensive DR models to evaluate factors that impact quality. Prematurity is a major clinical problem with enormous societal burden and cost, affecting one in ten deliveries in the US. DR resuscitation is paramount to the survival of extremely premature neonates. Unfortunately, significant variation in DR practices and outcomes exist within the US. This variation emphasizes the need for improved and consistent care. Unfortunately, there are no comprehensive approaches to assess DR care, and no validated DR quality metrics exist to help explain and rectify this variation. Leveraging HF methodology in a multicenter study, Dr. Herrick’s research proposal will fill this knowledge gap by (1) performing and in-depth works systems analysis of DR resuscitation to identify systematic factors that impact process and outcome variation, (2) identifying and refining DR quality metrics using a modified Delphi Process, and (3) testing reliability and validity of consensus quality metrics. Dr. Herrick’s K08 studies will address the critical gap of lack of DR quality metrics. The findings from these studies will directly inform future R01 proposals aimed at decreasing variation to optimize neonatal resuscitation. Her career development plan outlines a clear path to gain the knowledge, skills, and experience needed to gain independence as a health services research scientist and to become a leader in the application of human factors to neonatal resuscitation.