CLINICAL PERFORMANCE MEASURE FOR PEDIATRIC BRAIN INJURY

获得性脑损伤儿童是康复专科医院需要患者护理的最大诊断群体。为了进行认证，这些医院现在被要求收集大量患者群体的绩效衡量数据。这项任务是一个严重的两难境地，因为目前儿科康复方面的业绩衡量标准不足以指导内部改进或评估相对业绩。在进行了广泛的文献回顾和咨询该领域的专家后，在第一阶段，我们设计了一个包含44个项目的原型演奏工具。该工具侧重于脑损伤儿童的三个关键内容领域：1)日常活动，2)社交和行为能力，3)社区准备技能。在研究项目的第二阶段，我们将在8个随机选择的机构对患者进行前瞻性调查，修改项目内容，进行信度和效度分析，并为预期功能水平制定经风险调整的基准。风险调整方法旨在满足卫生组织认证联合委员会(JCAHO)对批准新工具的要求。第二阶段的最终产品将是一种适用于后天脑损伤儿童的可销售的性能测量系统，该系统将满足认证和合同机构的内容和测量要求。建议的商业应用：该SBIR项目的产品将是一种适用于儿童脑损伤儿童的适销对路的性能测量系统。自1998年起，所有获得JCAHO认证的医院都需要与一个数据系统签约，以便为大量患者群体提供比较数据。这一绩效衡量标准符合JCAHO的所有要求，并将填补住院儿科康复计划的关键空白。许多急诊儿童医院可能也会发现，这一措施有助于比较直接出院的儿童的创伤护理表现。

Children with acquired brain injuries comprise the largest diagnostic group requiring in patient care in specialized rehabilitation hospitals. For accreditation purposes, these hospitals are now required to collect performance measure data for high-volume patient groups. This mandate presents a serious dilemma, since current performance measures in pediatric rehabilitation are inadequate to guide internal improvements or to evaluate comparative performance. After conducting an extensive literature review and consulting experts in the field, in Phase I we designed a 44-item prototype performance instrument. The instrument focuses on three critical content areas for brain-injured children: 1) daily activities, 2) social and behavioral competence, and 3)community readiness skills. In Phase II of the research project, we will conduct a prospective survey of patients in 8 randomly selected facilities, revise the item content, conduct reliability and validity analyses, and develop risk-adjusted benchmarks for expected levels of functioning. The risk adjustment methodology is designed to meet the Joint Commission for the Accreditation of Health Organization's (JCAHO) requirements for approving new instruments. The final product of Phase II will be a marketable performance measurement system for children with acquired brain injury that will meet content and measurement requirements of accreditation and contracting agencies. PROPOSED COMMERCIAL APPLICATIONS: The product of this SBIR project will be a marketable Performance Measurement System for children with Pediatric Brain Injury. As of 1998, all JCAHO accredited hospitals need to contract with a data system to provide comparative data for high-volume patient groups. This Performance Measure meets all the JCAHO requirements and will fill a critical void for in patient pediatric rehabilitation programs. Many acute care children's hospitals may also find this measure helpful in comparing performance of trauma care for children who are directly discharged home.