Development and Validation of a Scorecard of Neonatal Intensive Care Quality

描述(由申请人提供)：我的研究议程寻求发展一个新生儿重症监护病房(NICU)质量的记分卡。背景：由于临床实践中广泛差异的认识，关于医疗有效性的证据的增加，以及对医疗保健成本和质量的日益关注，对比较质量测量和评估的兴趣大大增加。在医学的其他领域，绩效记分卡提高了医疗机构、提供者和患者护理的质量。具体目标：我寻求K23奖项，以发展成为一名独立的调查员，并成为衡量新生儿保健质量的专家。具体地说，我建议为极低出生体重儿(小于1500克)开发一种新生儿重症监护质量记分卡。目的1：选择包含在NICU护理质量记分卡中的措施目标2：构建记分卡并根据其绩效目标对NICU进行排名3：评估针对替代计分卡构建方法的NICU排名及其随时间的稳定性。目的4：验证记分卡方法：记分卡的开发将采用主要数据收集(专家小组和调查)和对研究水平的临床数据库进行分析。一个多学科指导委员会将指导研究议程的进展，该委员会的专长涉及质量评估和改进相关学科(Petersen博士和Kallen博士)以及新生儿学和卫生服务研究(Gould博士和Zupancic博士)。此外，我还有在新生儿学(斯塔克博士)、患者安全和调查方法(托马斯博士)和生物统计学(皮耶茨博士)方面有专长的科学顾问。他们的指导，以及由K23奖项推动的重点培训和研究计划，将通过提供关键的内容和方法培训，发展我在新生儿质量研究方面的专业知识。结论：教育和研究议程旨在补充我之前在新生儿学和卫生服务研究方面的培训，并将使我能够实现我的目标，即在以患者为导向的临床研究领域发展独立的职业生涯，同时促进NICHD的使命，即确保所有儿童都有机会充分发挥他们的潜力，过上健康和富有成效的生活。

DESCRIPTION (provided by applicant): My research agenda seeks to develop a scorecard of neonatal intensive care unit (NICU) quality. Background: Interest in comparative quality measurement and evaluation has grown considerably because of recognition of the widespread variation in clinical practice, increased availability of evidence about medical effectiveness, and increasing concerns about the cost and quality of healthcare. In other fields of medicine, scorecards of performance have improved the quality of healthcare institutions, providers, and patient care. Specific Aims: I seek a K23 award to develop into an independent investigator and to become expert in the measurement of the quality of neonatal healthcare. Specifically, I propose to develop a scorecard of neonatal intensive care quality for very low birthweight infants (less than 1500 grams). Aim 1: To select measures for inclusion in the scorecard of NICU quality of care Aim 2: To construct a scorecard and rank NICUs according to their performance Aim 3: To evaluate NICU rankings in response to alternative methods of scorecard construction as well as their stability over time. Aim 4: To validate the scorecard Methods: The development of the scorecard will employ primary data collection (expert panels and surveys) and analysis of a research level clinical database. A multi-disciplinary mentoring committee whose expertise spans the relevant disciplines of quality assessment and improvement (Drs. Petersen and Kallen) as well as neonatology and health services research (Drs. Gould and Zupancic) will guide the progress of the research agenda. In addition, I have scientific advisors with expertise in neonatology (Dr. Stark), patient safety and survey methodology (Dr. Thomas), and biostatistics (Dr. Pietz). Their mentorship, as well as a focused training and research plan facilitated by a K23 award, will develop my expertise in neonatal quality research by providing crucial content and methodological training. Conclusion: The educational and research agenda are designed to complement my previous training in neonatology and health services research, and will enable me to achieve my goal of developing an independent career in patient-oriented clinical research while furthering the NICHD's mission of ensuring that all children have the chance to achieve their full potential for healthy and productive lives.