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，还有更多的患者因医疗错误而受伤。托马斯博士和他的一名学员的研究表明，儿童在这些死亡中占很大比例，每年有70 000名儿童因医院护理而受伤。除了错误，儿科医疗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，医疗质量和安全性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，托马斯博士将大部分时间用于研究医疗质量和安全性。他现在有经验和制度环境，成功地指导个人谁将致力于他们的职业生涯进行研究，以提高儿科质量和安全。托马斯博士有指导的记录，一个国家和国际研究的声誉，他在休斯顿得克萨斯大学医学院担任关键的研究培训领导角色。此外，UT休斯顿有一个由NIH CTSA赠款，AHRQ质量和安全培训赠款fnded优秀的研究培训计划，和博士托马斯指导UT纪念赫尔曼中心的医疗质量和安全。托马斯博士希望在头2-3年每年招募两名学员，然后一次指导不超过5或6名学员。他将投入25%的精力指导和25%的努力在此应用程序中概述的研究计划。该奖项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。最初的研究将在模拟器中进行，然后是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，还将对诊断错误进行研究，提高传染病儿童隔离的依从性，制定新生儿ICU的质量措施，衡量和改善安全文化，并改善从NICU到家庭和门诊医疗护理的护理过渡。 公共卫生相关性：在美国的医疗保健系统中，儿童经常遭受医疗错误，过度使用无效护理和有效护理不足。该申请寻求资金支持托马斯博士的时间，作为未来的领导者在儿科医疗质量和安全领域的导师。这里提出的研究，以及随后由托马斯博士的学员进行的研究，将产生新的知识，以改善儿科医疗保健。

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.