Improving the Safety and Quality of Pediatric Health Care

描述(由申请人提供)：在美国，每年至少有44,000名患者死亡，更多的人因医疗差错而受伤。托马斯博士和他的一名受训者的研究表明，在这些死亡病例中，儿童占了相当大的比例，每年有7万名儿童在医院的护理中受伤。除了错误，儿科保健还充斥着对有效护理的使用不足和对无效护理的过度使用。正如Tom Boat在两篇重要文章中指出的那样，医疗质量和安全方面的研究培训应该是美国儿科研究议程的核心组成部分。14年来，托马斯博士一直致力于医疗质量和安全方面的研究。他现在拥有成功指导个人的经验和制度环境，这些个人将把自己的职业生涯奉献给改善儿科质量和安全的研究。托马斯博士有指导经验，在国内和国际上享有盛誉，他在休斯顿的德克萨斯大学医学院担任重要的研究培训领导职务。此外，德克萨斯大学休斯顿分校有一个杰出的研究培训项目，由NIH CTSA拨款资助，AHRQ质量和安全培训拨款资助，Thomas博士是德克萨斯大学赫尔曼纪念医疗质量和安全中心的负责人。托马斯博士希望在最初的2-3年里每年招募两名学员，然后一次辅导不超过5到6名学员。他将把25%的精力投入到指导中，25%的精力投入到本申请中概述的研究计划中。为该奖项提出的研究将测试团队培训干预措施，以提高团队合作和新生儿复苏的技术质量。初步研究将在模拟器中进行，随后将进行两个中心的试点研究，以评估对低出生体重儿复苏的影响。此外，还将研究诊断错误，提高对患有传染病的儿童隔离的依从性，制定新生儿ICU的质量措施，衡量和改进安全文化，以及改善从NICU到家庭和门诊医疗的护理过渡。

DESCRIPTION (provided by applicant): At least 44,000 patients die each year in the U.S. and numerous more are injured as a result of medical errors. Research by Dr. Thomas and one of his mentees shows that children comprise a significant proportion of these deaths and that 70,000 children are injured by care in hospitals each year. In addition to errors, pediatric healthcare is fraught with under use of effective care and over use of ineffective care. As Tom Boat notes in two important articles, research training in healthcare quality and safety should be central components ofthe pediatric research agenda in the United States. For 14 years Dr. Thomas has committed the majority of his time to research on healthcare quality and safety. He now has the experience and institutional environment to successfully mentor individuals who will dedicate their careers to conducting research to improve pediatric quality and safety. Dr. Thomas has a track record of mentoring, a national and international research reputation, and he holds key research training leadership roles at The University of Texas Medical School at Houston. Furthermore, UT Houston has an outstanding reseach training program fnded by a NIH CTSA grant, an AHRQ training grant for quality and safety, and Dr. Thomas directs the UT-Memorial Hermann Center for Healthcare Quality and Safety. Dr. Thomas expects to recruit two mentees per year for the first 2-3 years then mentor no more than 5 or 6 six mentees at a time. He will devote 25% effort to mentoring and 25% effort to the research plan outlined in this application. The research proposed for this award will test team training interventions to improve teamwork and the technical quality of neonatal resuscitation. Initial studies will be conducted in a simulator, followed by a two-center pilot study to assess the effect on the resuscitation of low birthweight infants. In addional, research wil be conducted on diagnostic errors, improving compliance with isolation of children with contagious diseases, developing quality measures for neonatal ICUs, measuring and improving safety culture, and improving care transitions fr-om the NICU to home and outpatient medical care.