Improving the Safety and Quality of Pediatric Health Care

描述（由申请人提供）：美国每年至少有44,000名患者死于医疗事故，更多的人受伤。托马斯博士和他的一名学员的研究表明，儿童在这些死亡人数中占很大比例，每年有70 000名儿童因在医院接受护理而受伤。除了错误，儿科保健充满了有效护理的使用不足和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，Thomas博士致力于医疗质量和安全的研究。他现在有经验和机构环境，可以成功地指导那些将致力于开展研究以提高儿科质量和安全的个人。Thomas博士拥有指导经验，在国内和国际研究领域享有盛誉，并在The University of Texas Medical School at Houston担任重要的研究培训领导职务。此外，德州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，托马斯博士指导德克萨斯大学纪念赫尔曼医疗质量和安全中心。Thomas博士希望在前2-3年每年招募两名学员，然后每次指导不超过5或6名学员。他将把25%的精力用于指导，25%的精力用于本申请中概述的研究计划。该奖项的研究将测试团队训练干预措施，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，随后是一项双中心试点研究，以评估对低出生体重婴儿复苏的影响。此外，还将对诊断错误进行研究，改善对患有传染病的儿童进行隔离的依从性，制定新生儿重症监护病房的质量措施，衡量和改善安全文化，以及改善从新生儿重症监护病房到家庭和门诊医疗护理的护理过渡。

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. PUBLIC HEALTH RELEVANCE: In the United States healthcare system children often suffer from medical errors, the overuse of Ineffective care, and underuse of effective care. This application seeks funding to support Dr. Thomas' time to serve as mentor for future leaders in the field of pediatric healthcare quality and safety. The studies proposed here, and those subsequently performed by Dr. Thomas' mentees, will generate new knowledge to improve tiediatric healthcare.