Leveraging Human Factors to Evaluate Quality of Neonatal Delivery Room Care

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PROJECT SUMMARY/ABSTRACT The purpose of this Mentored Clinical Scientist Research Career Development Award (K08) is to prepare Heidi M. Herrick, MD MSCE, Clinical Instructor and Attending Physician at the Children’s Hospital of Philadelphia and the Hospital of the University of Pennsylvania for her long-term goal of becoming an independent health services research scientist with expertise in Human Factors (HF) and its application to neonatal resuscitation. Her long-term career objective is to apply HF methodology to neonatal resuscitation to improve provider resuscitation performance and neonatal outcomes. Her immediate goal is to acquire the mentorship, training, and research experience needed to successfully compete for R01 grants aimed at optimizing neonatal resuscitation to decrease variation in DR practices and outcomes. To achieve these goals and transition to independence, Dr. Herrick and her mentors have developed a comprehensive career development plan based on the following: (1) intensive mentorship from a team with whom she has a proven track record of collaboration and scholarship; (2) advanced training in HF in complex systems, quality metric development, and qualitative methodology; (3) mentored leadership positions, and (4) an innovative research plan to use a HF framework to define and validate DR quality metrics and to develop comprehensive DR models to evaluate factors that impact quality. Prematurity is a major clinical problem with enormous societal burden and cost, affecting one in ten deliveries in the US. DR resuscitation is paramount to the survival of extremely premature neonates. Unfortunately, significant variation in DR practices and outcomes exist within the US. This variation emphasizes the need for improved and consistent care. Unfortunately, there are no comprehensive approaches to assess DR care, and no validated DR quality metrics exist to help explain and rectify this variation. Leveraging HF methodology in a multicenter study, Dr. Herrick’s research proposal will fill this knowledge gap by (1) performing and in-depth works systems analysis of DR resuscitation to identify systematic factors that impact process and outcome variation, (2) identifying and refining DR quality metrics using a modified Delphi Process, and (3) testing reliability and validity of consensus quality metrics. Dr. Herrick’s K08 studies will address the critical gap of lack of DR quality metrics. The findings from these studies will directly inform future R01 proposals aimed at decreasing variation to optimize neonatal resuscitation. Her career development plan outlines a clear path to gain the knowledge, skills, and experience needed to gain independence as a health services research scientist and to become a leader in the application of human factors to neonatal resuscitation.