Pursuing Perfection in Pediatric Theraputics

描述（由申请人提供）：我们的目标是建立一个儿科治疗学教育和研究中心（CERTs）研究中心（RC），其主题是通过优化治疗学的使用来改善儿童的护理和结果。次主题是质量和安全。凭借辛辛那提儿童医院医疗中心（CCHMC）的核心基础设施和区域和国家合作伙伴关系，以加强推广并转化为实践和政策，可以实现患者安全、相对有效性和护理改进方面的重大创新。计划开展五个项目：1)通过使用态势感知（一种高可靠性策略）减少不安全的ICU转移和对治疗干预的需求；2)预测

DESCRIPTION (provided by applicant): We aim to establish a pediatric Center for Education and Research on Therapeutics (CERTs) Research Center (RC) with the theme of improving care and outcomes for children by optimizing the use of therapeutics. Subthemes are quality and safety. With a core infrastructure at Cincinnati Children's Hospital Medical Center (CCHMC) and regional and national partnerships to enhance spread and translation into practice and policy, significant innovations in patient safety, comparative effectiveness and improvements in care can be achieved. Five projects are planned: 1) Reduce unsafe ICU transfers and the need for therapeutic interventions by using situation awareness, a high reliability strategy; 2) Predict and prevent acute kidney injury in hospitalized children receiving nephrotoxic medications by testing, refining, and spreading a trigger tool and mitigation intervention; 3) Compare the effectiveness of antibiotics for the most common serious bacterial infection in children, community acquired pneumonia, using a health system population database; 4) Evaluate diffusion and implementation strategies to prevent prematurity and related lung problems by using antenatal corticosteroids and 17-hydroxyprogesterone, in a statewide perinatal network; and 5) Ensure safe use of disease-modifying anti-rheumatic drugs, and develop a shared decision-making tool, in a pediatric network for the 6th most common cause of childhood disease, arthritis. We will use CCHMC and Learning Networks (multi-site collaborations of patients/families, clinicians, and researchers) as the innovation engines and laboratories that can help standardize care so that new approaches can be evaluated effectively and efficiently to improve therapeutic care and health outcomes for children. In addition, we propose activities that explore planned experimentation in complex health systems, and the ethics and data sharing policies needed to enable large registry studies. PUBLIC HEALTH RELEVANCE: Children have unique needs, types and severity of illness that create special challenges for pediatric therapeutics. Their care is suboptimal. This CERTs will focus on translating research into practice to improve quality and safety so that every child gets the right therapeutic at the right time in the right way--every time.