Pursuing Perfection in Pediatric Theraputics

描述(由申请者提供)：我们的目标是建立一个儿科治疗教育和研究中心(CERTs)研究中心(RC)，其主题是通过优化治疗方法的使用来改善儿童的护理和结果。副主题是质量和安全。随着辛辛那提儿童医院医疗中心(CCHMC)的核心基础设施以及区域和国家合作伙伴关系的加强传播并转化为实践和政策，可以在患者安全、相对有效性和改善护理方面实现重大创新。计划了五个项目：1)通过使用情况感知减少不安全的ICU转移和治疗干预的需要，这是一种高可靠性的战略；2)预测 3)利用卫生系统人口数据库，比较抗生素对儿童最常见的严重细菌感染--社区获得性肺炎--的疗效；4)在全州范围的围产期网络中，评估通过使用产前皮质类固醇和17-羟孕酮来预防早产和相关肺部问题的传播和实施策略；以及5)确保修改疾病的抗风湿药物的安全使用，并在儿童疾病的第6大常见原因关节炎的儿科网络中开发一个共享的决策工具。我们将使用CCHMC和学习网络(患者/家庭、临床医生和研究人员的多站点合作)作为创新引擎和实验室，帮助标准化护理，以便能够有效和高效地评估新方法，以改善儿童的治疗护理和健康结果。此外，我们建议开展活动，探索在复杂的卫生系统中进行有计划的实验，以及实现大型注册研究所需的伦理和数据共享政策。 与公共卫生相关：儿童有独特的需求、疾病类型和严重程度，这给儿科治疗带来了特殊的挑战。他们的护理是次优的。CERT将专注于将研究转化为实践，以提高质量和安全性，以便每个儿童都能在正确的时间以正确的方式--每次--获得正确的治疗。

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.