Optimizing safety of mother and neonate in a mixed methods learning laboratory

描述（由申请人提供）：随着认识到医疗保健往往提供不良，不足，过于昂贵，没有好处，有越来越多的审查在美国的医疗保健的安全性和质量两个相互关联的临床领域是在一个新生阶段的研究，病人的安全是孕产妇和新生儿护理。与其他发达国家相比，美国的孕产妇和新生儿死亡率仍然较高，我们有一个令人兴奋的机会，可以通过多学科方法来推进医疗保健安全科学，包括定性研究方法，设计思想，模拟，对照试验和实施科学。该项目将重点关注围产期护理的安全性，重点关注分娩和分娩，这是美国住院治疗的最常见原因。从我们的方法中学到的原则也可以用于研究医院其他领域的安全问题。因此，该项目不仅有助于提高母亲和新生儿的安全和质量，而且还有助于医疗保健安全的一般科学。我们的建议也将有可能对患者的结果产生直接影响，因为研究的各个阶段必然会在患者护理环境中进行。在这个拟议的项目中，我们将执行的工作，将：1）建立围产期安全学习实验室，2）开发和测试最佳的新生儿复苏数据显示，3）开发和测试最佳的产妇数据显示，4）开发一个过程，以识别和防止产妇临床恶化，和5）开发一个劳动和分娩套房的最佳物理设计。我们的安全学习实验室将在四个相互关联的项目上开展工作：项目#1：新生儿复苏的最佳交互式数据显示。项目#2：一个最佳的数据显示劳动和交付。项目3：提高对产妇临床恶化的认识，项目4：最佳分娩室的物理设计。我们将通过建立安全学习实验室，汇集产科，妇科，护理，设计专家，工程师和家长代表，并使用模拟方法来开发，试点和测试四个项目中的创新设计，扩大新生儿和孕产妇护理患者安全的知识基础。

DESCRIPTION (provided by applicant): With the recognition that medical care is often poorly provided, deficient, and excessively costly without benefit, there has been increasing scrutiny on the safety and quality of healthcare in the U.S. Two interrelated clinical areas that are at a nascent stage in the study of patient safety are maternal and neonatal care. As the U.S. continues to have higher maternal and neonatal mortality compared to other developed countries, we have an exciting opportunity to advance the science of safety in healthcare with a multidisciplinary approach including qualitative research methods, design thought, simulation, controlled trials, and implementation science. This project will focus on the safety of perinatal care, with a focus on labor and delivery, which is the most common reason for hospitalization in the U.S. The principles learned from our approach may also serve to study safety issues in other areas of the hospital. Therefore, this project has the potential to not only contribute to improving safety and quality for mothers and newborns, but also contribute to the general science of safety in healthcare. Our proposal will also have the potential to have an immediate impact on patient outcomes, as stages of the research will necessarily be carried out in patient care settings. In this proposed project, we will perform work that will: 1) establish a perinatal safety learning laboratory, 2) develop and test an optimal neonatal resuscitation data display, 3) develop and test an optimal maternal data display, 4) develop a process to recognize and prevent maternal clinical deterioration, and 5) develop the optimal physical design of a labor and delivery suite. Our safety learning laboratory will perform work on four interrelated projects: Project #1: An optimal interactive data display for neonatal resuscitation. Project #2: An optimal data display for labor and delivery. Project #3: Improving recognition of maternal clinical deterioration, and Project #4: Physical design of the optimal delivery suite. We will expand the knowledge base on patient safety for neonatal and maternal care by establishing a safety learning laboratory, bringing together obstetrics, neonatology, nursing, design specialists, engineers, and parent representatives, and using simulation methodology to develop, pilot, and test innovative designs in the four projects.