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够高且不公平。人们应该得到的护理与他们确实得到的护理之间存在着巨大的差距。尽管大部分质量不达标的证据来自成人的临床护理，但有关儿童的有限数据表明，他们的护理质量相对较低。2009年《儿童健康保险计划再授权法》(CHIPRA)要求建立一个国家儿科质量措施计划(PQMP)，以召集专家，征求公众意见，并建设基础设施，为不同的环境和不同的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质量测量卓越中心(COE)，以开发、增强和测试儿童质量测量方法，并确保它们准备好广泛使用。COE将是一个全面的质量衡量发展中心，拥有研究专业知识、临床经验，并直接接触到转变质量衡量所需的不同医疗保健提供模式和患者群体。通过创建COE，我们的目标是：1)建立一个由学术、临床、付款人、提供者和患者群体组成的强大网络，共同在儿科质量测量开发、测试、实施和分析方面提供卓越的能力；2)开发和增强AHRQ指定的遵循公共流程的儿科质量测量；3)在临床范围内的多个环境中与广泛的最终用户一起测试测量，并确保测量旨在识别医疗保健方面的差异；以及4)向AHRQ提供可操作的测量，并提供详细的规范，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，引领改进测量、测试和使用的创新方法的开发。我们将建议改进有意义地使用电子健康记录(EHR)和索赔系统，以实现跨所有区域和设置的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的护理差距，以及所制定的所有措施的价值和成本效益。我们在CHIPRA优先制定措施的所有5个领域都有能力，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质量测量卓越中心，以开发、增强和测试儿科质量测量。我们的目标是建立一个由学术、临床、付款人、提供者和患者群体组成的强大网络，共同在儿科质量测量方面提供卓越的能力。我们将确保采取措施，以确定护理方面的差距。

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.