Role of individual and hospital factors in quality of care for children in EDs

个人和医院因素对急诊室儿童护理质量的作用

• 批准号: 10870666
• 负责人: Margaret Emily Samuels-Kalow
• 金额: $ 4.84万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10870666
• 关键词: Accident and Emergency department; Accounting; Address; Admission activity; Affect; Caring; Case Mixes; Characteristics; Child; Child Care; Child Health; Childhood; Clinical; Data; Databases; Disparity; Emergency Care; Emergency Medicine; Emergency department visit; Ensure; Equipment; Equipment and supply inventories; Ethnic Origin; Evidence based intervention; Face; Geography; Goals; Grant; Health Care Costs; Health Services Research; Hospital Mortality; Hospitals; Image; Individual; Inpatients; Insurance; Insurance Coverage; Interview; Investigation; Knowledge; Link; Measures; Mediator; Minority; Mission; National Institute of Child Health and Human Development; Nurses; Outcome; Patients; Pediatric Hospitals; Physicians; Policies; Population; Process; Public Health; Quality of Care; Race; Readiness; Reduce health disparities; Research; Resources; Role; Strategic Planning; System; Training; Travel; United States; United States Agency for Healthcare Research and Quality; Variant; Visit; Work; administrative database; adolescent health; care outcomes; disparity reduction; emergency settings; experience; health care disparity; health disparity; implementation determinants; improved; improved outcome; interest; medical specialties; member; mortality; multilevel analysis; pediatric emergency; pediatric patients; process improvement; social

Abstract Although most children receive emergency care in general emergency departments (EDs), national studies have shown that pediatric readiness is low and that the lack of readiness has consequences for clinical quality and outcomes. Presentation to a highly prepared hospital, one with a high pediatric readiness score, is associated with decreased in-hospital mortality. Presence of a pediatric emergency care coordinator (PECC) is associated with increased readiness, but limited data are available to directly assess the association between PECC status and quality of care for children. Previous work has focused primarily on quality variation among specialty pediatric centers which account for a minority of care provided to pediatric patients and have very different staffing and resources as compared to general EDs. Our long-term goal is to develop systems to improve care for children presenting to general EDs. The goal of this R01 project is to define the hospital-level characteristics associated with quality of care provided to children in general EDs. We will use a slate of recently developed process and outcome quality measures across geographically diverse states with high- quality pediatric data available. Our primary hypothesis is that more intensive pediatric-focused staffing (e.g. more robust PECC implementation) is associated with higher-quality care and better clinical outcomes for children. The specific aims are to (1) Identify PECC implementation factors that are associated with variation in quality of emergency care for children (2) Establish if PECC status is associated with higher quality of care for children treated in general EDs and (3) Determine if disparities in quality of care by race/ethnicity and insurance vary by PECC status. The proposed work builds on our pilot work with the National ED Inventory (NEDI-USA) database, as well as on our team’s strong track record in health services research with large administrative databases and qualitative and implementation expertise. In the proposed work, we fulfill two of the primary goals of the NICHD Strategic Plan: (1) “improving child and adolescent health” and (2) addressing “pervasive disparities…improving approaches in populations that experience specific cultural, social, or access issues.” These data will provide a critical understanding of the association between PECC, workforce factors, and quality of care for children. This understanding is the prerequisite for developing evidence-based interventions to improve outcomes for all children receiving emergency care in general EDs.

摘要

项目成果

Parallels Between Efforts to Improve Geriatric and Pediatric Emergency Care.

改善老年和儿童急诊护理工作的相似之处。

• DOI: 10.1016/j.annemergmed.2022.05.005
• 发表时间: 2022
• 期刊: Annals of emergency medicine
• 影响因子: 6.2
• 作者: Boggs,KrislynM;Sullivan,AshleyF;Samuels-Kalow,MargaretE;CamargoJr,CarlosA
• 通讯作者: CamargoJr,CarlosA

A Comparison of State-Specific Pediatric Emergency Medical Facility Recognition Programs, 2020.

2020 年各州特定儿科紧急医疗机构认可计划的比较。

• DOI: 10.1097/pec.0000000000003119
• 发表时间: 2024
• 期刊: Pediatric emergency care
• 影响因子: 1.4
• 作者: Boggs,KrislynM;Voligny,Emma;Auerbach,Marc;Espinola,JaniceA;Samuels-Kalow,MargaretE;Sullivan,AshleyF;CamargoJr,CarlosA
• 通讯作者: CamargoJr,CarlosA