Workload, Workforce, and Quality of Care in Pediatric Hospitals

项目摘要/摘要 在本研究计划中，我们考察了工作负荷的动态方面之间的关联， 儿童医院的劳动力和护理质量，并寻求解决方法问题 衡量医院利用率的问题，特别是在普通儿科护理环境中。我们 采用多学科方法通过以下方式了解患者流动的复杂性 应用循证管理和运筹学来理解能力 可能与医院环境中的需求/需要相匹配，以及 这关系到医疗服务的质量、安全性、有效性和效率。结果是 该项目的实施将为卫生服务研究人员、医院领导、 监管机构和培训计划，以掌握劳动力的具体失衡- 工作量匹配，导致低效或降低护理质量。 前期工作的重点是制定和验证住院患者的管理措施 工作负载、劳动力和选定的高质量终端(例如，住院时间派生、用药 错误、安全事件和重新入院)。AIM 1将完成中概述的验证 初步研究，以确定用于确定动态管理数据的准确性 衡量学术儿童医院的工作量、劳动力和护理质量。目标2 将确定与住院时间、重新入院时间和 常见儿科诊断的儿童用药差错。今后的工作目标是 制定预测规则并检查操作策略，以预防或应对 工作量和劳动力不匹配，以优化质量和安全。终极目的 该项目的目的是帮助临床医生和管理员在 儿科医院设置实现安全、有效、高效、及时、以患者为中心 对住院儿童的公平照顾。

Project Summary/Abstract In this research plan, we examine associations between dynamic aspects of workload, workforce, and quality of care at children's hospitals and seek to address methodological problems of measuring utilization at hospitals, particularly in a general pediatric care setting. We adopt a multidisciplinary approach to understanding the complex nature of patient flow by applying evidence-based management and operations research to understanding how capacity may be matched to demand/need in a hospital setting and the consequences of imbalance in this relationship for quality, safety, effectiveness and efficiency of care delivered. The outcomes of this project will provide valuable tools for health services researchers, hospital leadership, regulatory agencies, and training programs to grasp the specific imbalances of workforce- workload matching that result in inefficiency or reduced quality of care. Preliminary work has focused on developing and validating administrative measures of inpatient workload, workforce, and selected quality endpoints (e.g., length of stay derivatives, medication errors, safety events, and readmissions). Aim 1 will complete the validation outlined in preliminary studies to determine the accuracy of administrative data used to determine dynamic measures of workload, workforce, and quality of care at an academic children's hospital. Aim 2 will identify workload and workforce factors associated with length of stay, readmission, and medication errors for children with common general pediatrics diagnoses. Future work aims to develop a prediction rule and examine operational strategies to prevent or respond to periods of workload and workforce mismatch in order to optimize quality and safety. The ultimate purpose of this project is to help clinicians and administrators optimize workload-workforce balance in the pediatric hospital setting to achieve safe, effective, efficient, timely, patient-centered, and equitable care for hospitalized children.