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存在着巨大的差距。尽管许多关于质量不合格的证据来自成人的临床护理，但关于儿童的有限数据表明，他们的护理质量相对缺乏。2009年《儿童健康保险计划再授权法案》（CHIPRA）呼吁建立一个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操作的措施。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、加强和测试儿童质量测量，并确保它们准备好广泛使用。CoE将是一个全面的质量度量开发中心，拥有研究专业知识、临床经验，并可直接访问转换质量度量所需的各种医疗保健交付模型和患者群体。在创建CoE时，我们的目标是：1)建立一个由学术、临床、付款人、提供者和患者团体组成的强大网络，共同提供儿科质量测量开发、测试、实施和分析方面的卓越能力；2)制定和加强AHRQ指定的儿科质量措施，并遵循公共流程；3)在临床范围内的多种环境中与广泛的最终用户一起测试措施，并确保措施的设计能够识别护理方面的差异；4)向AHRQ提供具有详细规格的可操作措施，使其可以在整个医疗保健系统中使用。我们将利用最先进的卫生信息技术（HIT）和统计方法，带头开发创新方法，改进测量、测试和使用。我们将建议改进电子健康记录（EHR）和索赔系统的有效使用，以实现在所有地区和环境中有效和可靠的自动数据收集。我们将评估患者水平和实践水平在护理方面的差异，以及所制定的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。

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.