Pediatric Respiratory Illness Measurement System (PRIMES) Implementation in Community Hospital Settings

儿科呼吸疾病测量系统 (PRIMES) 在社区医院的实施

• 批准号: 10689215
• 负责人: RITA MANGIONE-SMITH
• 金额: $ 66.49万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689215
• 关键词: Abbreviations; Accident and Emergency department; Acute; Adherence; Admission activity; Applications Grants; Assessment tool; Asthma; Attitude; Belief; Bronchiolitis; Caring; Characteristics; Child; Childhood; Communities; Community Hospitals; Consensus; Consolidated Framework for Implementation Research; Data; Diagnosis; Evaluation Research; Funding; Future; Geography; Goals; Hospitalization; Hospitalized Child; Hospitals; Incentives; Individual; Inpatients; Intervention; Knowledge; Length of Stay; Link; Measurement; Measures; Medical Records; Medicine; Monitor; National Heart, Lung, and Blood Institute; Outcome; Patients; Pediatric Hospitals; Performance; Population; Practice Guidelines; Process; Prospective Studies; Provider; Quality of Care; Specific qualifier value; Structure; System; Thoracic Radiography; Variant; Work; care costs; care outcomes; cost; implementation barriers; implementation science; implementation strategy; improved; influenza virus vaccine; innovation; provider factors; respiratory; tool

Acute respiratory illness is a major cause of hospitalizations in the pediatric population with over 75% of admissions occurring in community–based (non-children's) hospitals. Focusing inpatient quality improvement (QI) efforts on these conditions is likely to have a significant impact on outcomes. The Pediatric Respiratory Illness Measurement System-Short Version (PRIMES-SV) tool is an abbreviated version of the previously developed and validated PRIMES quality assessment tool. Using medical records data, PRIMES-SV generates quality scores for both asthma and bronchiolitis, two of the most common conditions diagnosed in children admitted to community hospitals. The overall goals of this study are to demonstrate the sensitivity of PRIMES-SV measures to quality improvement (QI) interventions in community hospital settings, and to better understand the contextual and provider-level factors associated with both the ability to improve performance and to sustain those improvements. The specific aims of the study are: Aim 1. To implement the PRIMES-SV tool in six geographically diverse community hospitals to a) examine the degree of variation in performance across the hospitals and b) identify implementation barriers to high performance using the Consolidated Framework for Implementation Research (CFIR); Aim 2.To a) conduct a QI collaborative and improve overall performance on a sub-set of PRIMES-SV measures among the six hospitals by targeting CFIR-linked barriers with aligned strategies, and b) assess whether improved performance is associated with decreased LOS and costs; and Aim 3. To a) assess whether observed performance improvements are sustained on the targeted PRIMES-SV measures and b) determine which CFIR factors are linked with sustainment. These aims will be accomplished by bringing together a diverse group of experts in the fields of QI evaluation research, implementation science, and pediatric community-based hospital medicine. If using the proposed approach to QI is successful and improvements are sustained, the PRIMES-SV quality assessment tool used in combination with CFIR barrier-strategy matching could be widely disseminated to both community and children's hospitals to facilitate quality improvement for these common and high cost pediatric conditions.

急性呼吸道疾病是儿童住院的主要原因，超过 75% 入院发生在社区（非儿童）医院。聚焦住院质量提升 (QI) 针对这些条件所做的努力可能会对结果产生重大影响。小儿呼吸科 疾病测量系统-短版 (PRIMES-SV) 工具是之前版本的缩写版本 开发并验证了 PRIMES 质量评估工具。使用医疗记录数据，PRIMES-SV 生成哮喘和细支气管炎的质量评分，这两种最常见的疾病在 儿童被送往社区医院。本研究的总体目标是证明敏感性 PRIMES-SV 在社区医院环境中采取质量改进 (QI) 干预措施，并更好地 了解与提高绩效的能力相关的背景因素和提供商层面的因素 并维持这些改进。 该研究的具体目标是： 目标 1. 在六个不同地理区域实施 PRIMES-SV 工具 社区医院 a) 检查各医院绩效的差异程度，b) 确定 使用实施研究综合框架实现高性能的实施障碍 （CFIR）；目标 2.To a) 进行 QI 协作并提高 PRIMES-SV 子集的整体性能 六家医院采取一致的战略，针对与 CFIR 相关的障碍，并 b) 评估 性能的提高是否与服务水平和成本的降低有关；目标 3. a) 评估是否 观察到的性能改进在目标 PRIMES-SV 措施上持续存在，并且 b) 确定 其中 CFIR 因素与维持相关。 这些目标将通过汇集 QI 领域的不同专家群体来实现 评估研究、实施科学和儿科社区医院医学。如果使用 所提出的 QI 方法是成功的，并且持续改进，PRIMES-SV 质量评估 与 CFIR 障碍策略匹配结合使用的工具可以广泛传播到两个社区 和儿童医院，以促进这些常见且成本高昂的儿科疾病的质量改进。

项目成果

Vaccination Status and Adherence to Quality Measures for Acute Respiratory Tract Illnesses.

急性呼吸道疾病的疫苗接种状况和质量措施的遵守情况。

• DOI: 10.1542/hpeds.2019-0245
• 发表时间: 2020
• 期刊: Hospital pediatrics
• 作者: Bryan,MersineA;Hofstetter,AnnikaM;Simon,TamaraD;Zhou,Chuan;Williams,DerekJ;Tyler,Amy;Kenyon,ChénC;Vachani,JoyeeG;Opel,DouglasJ;Mangione-Smith,Rita
• 通讯作者: Mangione-Smith,Rita