Pursuing Perfection in Pediatric Therapeutics

描述(由申请人提供)：我们建议成立一个CERTS研究中心(RC)，其主题是通过优化治疗方法的使用来改善儿童的预后。其他副主题，预期影响超越儿科学，是药物基因组学和个性化药物，患者安全，以及质量改进方法。中心将与辛辛那提儿童医院医疗中心(公认的创新和改进领导者)、在评估科学、改进科学和教育方面的研究核心(由CCHMC卫生保健质量中心领导)以及能够向全国绝大多数儿科从业者和三级保健机构(美国儿科委员会(ABP；认证机构)、全国儿童医院及相关机构协会(NACHRI)、美国儿童医院公司(CHCA)、俄亥俄州医疗补助、辛辛那提大学药学院、UnitedHealth Group和几个家长组织)传播研究和教育计划的合作伙伴建立联系。在这一框架内，我们的具体目标是：1)创建一个研究核心，将在评估、卫生服务研究、质量改进方法、大型数据库分析、生活质量、慢性病和服药依从性方面具有广泛专业知识的个人聚集在一起；2)开发和实施一系列教育方法，从而在儿科人群中广泛改善治疗方法的使用。这些具体目标将部分通过处于不同创新和传播阶段的四个试点项目实现，这些项目将：1)测试药物遗传学测试对儿童利培酮治疗的影响；2)使用高可靠性方法减少药物不良事件造成的伤害；3)通过专科护理领域的协作网络改善慢性病儿童的预后，最初与儿科炎症性肠病网络(PIBDNet)合作，以改进药物管理；4)通过与美国儿科学会(AAP)合作，试点并传播促进使用最佳疗法的资源。尽管这些项目都侧重于儿童护理，但产生的方法和知识将远远超出儿科人口的范围，并将通过创造关于如何将药物遗传信息有效地整合到临床实践中、将高可靠性方法整合到护理系统中以及如何使用质量改进方法和协作学习来测试和加速创新扩散到实践中的新知识来推动治疗学领域的发展。

DESCRIPTION (Provided by the Applicant): We propose a CERTs Research Center (RC) with the theme of improving outcomes for children by optimizing the use of therapeutics. Additional sub-themes, with expected impact beyond pediatrics, are pharmacogenomics and personalized medicine, patient safety, and quality improvement methodology. The RC will link Cincinnati Children's Hospital Medical Center (an acknowledged leader in innovation and improvement), a research core skilled in evaluation science, improvement science, and education (led by the Center for Health Care Quality at CCHMC); and partners capable of disseminating research and education programs to the vast majority of the nation's pediatric practitioners and tertiary care settings (the American Board of Pediatrics (ABP; a certifying body), the National Association of Children's Hospitals and Related Institutions (NACHRI), Children's Hospital Corporation of America (CHCA), Ohio Medicaid, the University of Cincinnati School of Pharmacy, UnitedHealth Group, and several parent organizations). Within this framework, our specific aims are to: 1) Create a research core that brings together individuals with broad expertise in evaluation, health services research, quality improvement methods, analysis of large databases, quality of life, chronic illness, and medication adherence and, 2) Develop and implement a range of educational approaches that will result in broad improvements in the use of therapeutics in the pediatric population. These specific aims will be accomplished, in part, through four pilot projects at different stages of innovation and dissemination that will: 1) test the impact of pharmacogenetic testing on the treatment of children on risperidone; 2) decrease harm from adverse drug events using high reliability methods; 3) improve outcomes for children with chronic illness through collaborative networks in subspecialty care by working initially with the Pediatric Inflammatory Bowel Disease Network (PIBDNet) to improve medication management, and 4) pilot and disseminate resources that facilitate the use of optimal therapeutics by working with the American Academy of Pediatrics (AAP). Although these projects all focus on care for children, the methods and knowledge generated will go far beyond the pediatric population and will advance the field of therapeutics by creating new knowledge about how to integrate pharmacogenetic information effectively into clinical practice, high reliability methods into care systems, and how to use quality improvement methods and collaborative learning to test and accelerate the diffusion of innovations into practice.