ParentLink: Better and Safer Emergency Care for Children

ParentLink：为儿童提供更好、更安全的紧急护理

• 批准号: 6889837
• 负责人: STEPHEN C PORTER
• 金额: $ 36.15万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2006-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6889837
• 关键词: biomedical automation; biomedical equipment development; children; clinical research; computer assisted medical decision making; computer assisted patient care; data collection methodology /evaluation; emergency care; health care facility information system; health care quality; health services research tag; human subject; parents; patient safety /medical error

DESCRIPTION (provided by the applicant): The proposed work is informed by a mandate from the Institute of Medicine's Committee on Data Standards for Patient Safety which urges health systems to provide complete patient information and decision support to clinicians and their patients. This application, ParentLink: Better and Safer Emergency Care for Children, focuses on two specific areas highlighted in this Request for Applications (RFA) published by the Agency for Healthcare Research and Quality: 1) topic 1.9, the advantages and disadvantages of HIT use amongst stakeholders; and 2) topic 5.1, the generation of new knowledge and evidence for HIT. The emergency department (ED) constitutes a high-risk environment for errors and poor quality of care. Pediatric patients are at increased risk of medical errors. This applicant postulates that implementation of a patient-centered health information technology, ParentLink, can address system-level deficiencies and the unique "just-in-time" information needs of ED physicians and the parents of ill children. The proposed work delivers an innovative product: an electronic interface linked to a pediatric knowledge base that integrates parent-derived data with best practices for safe and effective emergency care across five common pediatric disease conditions. These disease conditions include: 1) occult bacteremia; 2) otitis media; 3) urinary tract infections; 4) asthma; and 5) head trauma. The study has two aims, the first of which addresses critical gaps in data capture: this project will evaluate the completeness and accuracy of information on symptoms, disease condition, medications and allergies generated by parents using ParentLink versus information documented by ED physicians and nurses, using structured telephone interviews as a gold standard. The second aim measures the ParentLink's impact on ED patient safety and quality, specifically: a) the error rate for ordering and prescribing of medications during ED care; and b) the percent of ED visits that adhere to national evidence-based guidelines. ParentLink will be rigorously evaluated in a clinical trial at two diverse ED sites, using a sequential, non-randomized observational design with two intervention and two control periods to measure effects of ParentLink on data capture and the safety and quality of patient care.

描述（由申请人提供）：拟议的工作是由医学研究所患者安全数据标准委员会的授权通知的，该委员会敦促卫生系统向临床医生及其患者提供完整的患者信息和决策支持。 此应用程序，ParentLink：更好和更安全的儿童紧急护理，侧重于医疗保健研究和质量机构发布的申请（RFA）中强调的两个特定领域：1）主题1.9，利益相关者使用HIT的优点和缺点; 2）主题5.1，HIT的新知识和证据的产生。 急诊室（艾德）构成了错误和护理质量差的高风险环境。 儿科患者发生医疗差错的风险增加。 本申请人假设，以患者为中心的健康信息技术ParentLink的实施可以解决系统级缺陷以及艾德医生和患病儿童父母独特的“及时”信息需求。 拟议的工作提供了一个创新的产品：一个电子界面链接到儿科知识库，集成了父母的数据与最佳实践，在五个常见的儿科疾病条件下安全有效的紧急护理。 这些疾病状况包括：1）隐性菌血症; 2）中耳炎; 3）尿路感染; 4）哮喘;和5）头部创伤。 该研究有两个目标，第一个目标是解决数据采集中的关键差距：该项目将评估父母使用ParentLink生成的症状，疾病状况，药物和过敏信息的完整性和准确性与艾德医生和护士记录的信息，使用结构化电话访谈作为金标准。 第二个目标衡量ParentLink对艾德患者安全和质量的影响，具体而言：a）艾德护理期间订购和开药的错误率;以及B）遵守国家循证指南的艾德就诊百分比。 将在两个不同的艾德研究中心进行的临床试验中对ParentLink进行严格评价，采用序贯、非随机观察设计，包括两个干预期和两个对照期，以测量ParentLink对数据采集以及患者护理安全性和质量的影响。