PA-20-070: The PIPA (Pediatric Inpatient Pathways for Asthma) Study: Optimizing Quality of Hospital Care for Children with Asthma

项目总结/文摘

PROJECT SUMMARY/ABSTRACT The COVID-19 pandemic has necessitated rapid changes in healthcare delivery in the US, including the care of hospitalized children. These changes (e.g., reducing non-urgent healthcare to maintain supplies and capacity for surges in COVID-19 cases) have had a variety of impacts on care quality and safety. We propose to identify major learnings from these changes in the care of hospitalized children and understand the intended and unintended consequences of these changes; this knowledge can be used to improve care quality during this or future pandemics or disasters. Dr. Kaiser is PI of an ongoing career development award funded by AHRQ. During this award, she led a national quality collaborative of 89 hospitals working to improve inpatient pediatric care.2,3 For this grant supplement, we have recruited leaders from 25 of these hospitals to participate in a qualitative study. Our specific aim is to identify major learnings from healthcare delivery changes during the COVID-19 pandemic and understand the potential quality and safety implications for hospitalized children. We will conduct purposeful sampling. We will recruit 2-3 participants from each of the 25 sites (total n=50-60 participants), including leaders of healthcare delivery planning (e.g., inpatient pediatric unit directors) and additional front-line clinicians. We have developed a semi-structured interview guide using the Hospital Disaster Resilience framework and “Health Systems Respond to COVID-19: Priorities for Rapid-Cycle Evaluation” by AcademyHealth. We will conduct an in- depth qualitative analysis using constant comparative methods to develop a conceptual model of major changes and learnings in healthcare delivery during the COVID-19 pandemic. We will also explore: 1) potential disparate effects on vulnerable groups of children, and 2) potential quality and safety implications. Our expected outcomes are an in-depth understanding of major changes and learnings in healthcare delivery for hospitalized children during the COVID- 19 pandemic, identification of potential implications for quality and safety of care, and selection of candidate quality metrics for future quantitative analyses of the impacts of COVID-19 pandemic on hospitalized children. Our findings can be rapidly and widely disseminated through our organizational partners to better enable hospitals to improve and monitor care quality for children.