Children's Hospital Boston Center of Excellence for Quality Measurement

描述（由申请人提供）：美国的医疗保健质量不足且不公平。人们应该得到的照顾和他们得到的照顾之间有很大的差距。虽然质量不合格的证据大多来自成人的临床护理，但关于儿童的有限数据表明，他们的护理质量很差。2009年儿童健康保险计划再授权法案（CHIPRA）呼吁建立国家儿科质量措施计划（PQMP），召集专家，征求公众意见，并建立基础设施，为各种环境和各种目的提供可行的措施。作为PQMP计划的一部分，我们建议建立波士顿儿童医院卓越质量测量中心（CoE），以开发，增强和测试儿童质量测量，并确保它们准备广泛使用。卓越中心将是一个全面的质量衡量开发中心，拥有研究专业知识、临床经验，并可直接访问转变质量衡量所需的各种医疗保健提供模式和患者人群。在创建卓越中心时，我们的目标是：1）建立一个强大的学术、临床、付款人、提供者和患者团体网络，共同提供儿科质量指标开发、测试、实施和分析方面的卓越能力; 2）按照公共流程开发和加强AHRQ分配的儿科质量指标; 3）在临床范围内的多种环境中测试各种措施，并确保措施旨在确定护理中的差异; 4）向AHRQ提供具有详细说明的可操作措施，使其可以在整个卫生保健系统中使用。我们将领导创新方法的开发，以改善测量，测试和使用，利用最先进的健康信息技术（HIT）和统计方法。我们将提出改进建议，以便有意义地使用电子健康记录（EHR）和索赔系统，以便在所有地区和环境中实现有效和可靠的自动数据收集。我们将评估患者层面和实践层面的护理差异，以及所有措施的价值和成本效益。我们在CHIPRA优先考虑的所有5个领域都有能力制定措施，特别是住院措施、健康结果措施和“最综合的卫生保健环境”措施。" 公共卫生相关性：我们建议创建波士顿儿童医院卓越质量测量中心，以开发，增强和测试儿科质量措施。我们的目标是建立一个强大的学术，临床，付款人，提供者和患者团体的网络，共同提供儿科质量测量的卓越能力。我们将确保采取措施，查明护理方面的差距。

DESCRIPTION (provided by applicant): The quality of healthcare in the United States is inadequate and inequitable. There is a wide gap between the care people should receive and the care they do receive. Although much of the evidence for substandard quality comes from clinical care for adults, the limited data on children suggest that the quality of their care is comparably lacking. The 2009 Child Health Insurance Program Reauthorization Act (CHIPRA) calls for the establishment of a national Pediatric Quality Measures Program (PQMP) to convene experts, solicit public input, and build infrastructure to provide actionable measures for diverse settings and for a variety of purposes. As part of the PQMP initiative, we propose to establish the Children's Hospital Boston Center of Excellence for Quality Measurement (CoE) to develop, enhance, and test child quality measures, and ensure that they are ready for widespread use. The CoE will be a comprehensive quality measure development center that has the research expertise, clinical experience, and direct access to diverse healthcare delivery models and patient populations that are needed to transform quality measurement. In creating the CoE, we aim to: 1) Build a strong network of academic, clinical, payer, provider, and patient groups that jointly provide exceptional capacity in pediatric quality measure development, testing, implementation, and analysis; 2) Develop and enhance pediatric quality measures assigned by AHRQ following a public process; 3) Test measures in multiple settings across the clinical spectrum with a wide range of end-users and assure that measures are designed to identify disparities in care; and 4) Deliver to AHRQ actionable measures with detailed specifications that make them ready to use across the health care system. We will lead the development of innovative approaches to improve measurement, testing, and use, drawing on state-of-the-art health information technology (HIT) and statistical methods. We will propose improvements for meaningful use of electronic health records (EHR) and claims systems to enable automated data collection that is valid and reliable across all regions and settings. We will assess patient-level and practice-level disparities in care, and the value and cost-effectiveness of all measures developed. We have capacity in all 5 areas prioritized by CHIPRA for measures development, especially inpatient measures, health outcome measures, and measures of the "most integrated health care settings." PUBLIC HEALTH RELEVANCE: We propose to create the Children's Hospital Boston Center of Excellence for Quality Measurement to develop, enhance, and test pediatric quality measures. We aim to build a strong network of academic, clinical, payer, provider, and patient groups that jointly provide exceptional capacity in pediatric quality measurement. We will assure that measures are designed to identify disparities in care.