Development and Validation of a Scorecard of Neonatal Intensive Care Quality

描述（由申请人提供）：我的研究议程旨在开发新生儿重症监护病房（NICU）质量记分卡。背景：由于认识到临床实践中的广泛差异，医疗有效性证据的可获得性增加，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价的兴趣已大大增加。在其他医学领域，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：我寻求一个K23奖，以发展成为一个独立的研究者，并成为在新生儿保健质量的测量专家。具体而言，我建议为极低出生体重婴儿（小于1500克）开发新生儿重症监护质量记分卡。目的1：选择纳入新生儿重症监护质量记分卡的措施；目的2：构建记分卡并根据其表现对新生儿重症监护病房进行排名；目的3：评估新生儿重症监护病房排名，以响应记分卡构建的替代方法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原始数据收集（专家小组和调查）和研究级临床数据库的分析。一个多学科的指导委员会，其专业知识涵盖质量评估和改进的相关学科(博士。Petersen和Kallen)以及新生儿学和健康服务研究(dr。Gould和Zupancic)将指导研究议程的进展。此外，我还有在新生儿学（Stark博士）、患者安全和调查方法（Thomas博士）和生物统计学（Pietz博士）方面具有专业知识的科学顾问。他们的指导，以及由K23奖推动的重点培训和研究计划，将通过提供关键内容和方法培训，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，并将使我能够实现在以患者为导向的临床研究中发展独立职业的目标，同时进一步推进NICHD的使命，确保所有儿童都有机会实现其健康和富有成果的生活的全部潜力。

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.