A Pediatric Quality Measurement Center and Testing Laboratory

描述(由申请人提供)：这是费城儿童医院(CHOP)提出的成为儿科质量测量计划(PQMP)卓越中心(COE)网络的一部分。CHOP已经形成了一个新的COE的组织架构，该架构建立在强大的现有基础设施的基础上，包括在质量和结果评估、独特的数据资源和战略合作伙伴关系方面具有广度和深度的领导力和方法专业知识的调查人员。COE将包括五个方法核心：(1)质量信息学--使用信息学工具使质量指标适应电子健康记录(EHR)；(2)多元匹配实验室--实验室将提供独特的分析力量，将增强传统分析方法，以创建科学严谨的儿科风险调整模型，更好地评估健康和医疗保健差距，并改进新质量衡量标准的有效性；(3)医院指标--制定侧重于住院质量的衡量标准；(4)医疗之家--衡量与之相关的医疗之家和社区服务的绩效；以及，(5)健康计划--特别强调衡量计划的投保期限和稳定性。该提案有6个具体目标：(1)形成新的CHOP COE的组织架构，致力于推进质量测量科学并有效参与PQMP；(2)加强儿科保健质量的核心衡量标准--避免对渗出性中耳炎不当使用抗菌治疗--使其适用于电子健康记录；(3)制定和验证儿科再入院结果措施，包括基于入院时获得的信息的传统再入院措施和基于出院时收集的信息的新的再入院措施，目的是评估与再入院有关的门诊护理；(4)制定和验证儿童健康保险覆盖措施的持续时间和稳定性；(5)加强发育筛查核心措施，使其适用于EHR，并将初级保健的筛查数据与接受基于社区的早期干预服务联系起来；以及(6)发展多变量匹配实验室，并将匹配方法应用于风险调整、差异评估和指标验证。CHOP COE将与几家儿童医院在儿科EHR数据共享网络(PEDSNet)和GE Healthcare医疗质量改进联盟多实践数据仓库中进行合作，该数据仓库包含1500多万份电子健康记录。与州医疗补助主任、宾夕法尼亚州独立蓝十字、临床医生、家庭和其他方面的利益相关者联盟将就所有拟议指标的适用性和重要性提供实质性意见。总之，凭借成功所必需的专业知识、数据、基础设施和联盟，CHOP COE提案高度响应了U18 RFA-HS-11-001的要求，并应为PQMP提供独特的价值。 公共卫生相关性：费城儿童医院正在提议成为儿科质量测量计划(PQMP)的卓越中心。我们独特的方法能力是使用EHR来衡量质量，开发创新的质量和结果衡量标准，以及用于风险调整和差距评估的统计方法。基于我们在结果和过程测量发展方面的丰富经验，我们建议了一个连贯的质量测量增强和发展计划，我们相信这将使整个PQMP财团受益，并有助于保证从这一雄心勃勃的计划制定的衡量标准将是最高水平的，并具有足够的规模和范围来改变儿童健康。

DESCRIPTION (provided by applicant): This is a proposal from the Children's Hospital of Philadelphia (CHOP) to become part of the Pediatric Quality Measures Program's (PQMP's) Centers of Excellence (CoE) network. CHOP has formed an organizational architecture for a new CoE that builds on a strong, existing infrastructure already in place including investigators with breadth and depth in leadership and methodological expertise in quality and outcome assessment, unique data resources, and strategic partnerships. The CoE will include five methodological cores: (1) Quality Informatics-using the tools of informatics to adapt quality metrics to the electronic health record (EHR); (2) Multivariate Matching Laboratory--The lab will provide a unique analytic strength that will augment traditional analytic approaches to create scientifically rigorous pediatric risk adjustment models, produce better assessment of health and healthcare disparities, and improve validation of new quality measures; (3) Hospital Metrics-development of measures that focus on inpatient quality; (4) Medical Home-measurement of the performance of the medical home and community services that connect to it; and, (5) Health Plans-a special emphasis on measurement of plan enrollment duration and stability. The proposal has 6 specific aims: (1) Form the organizational architecture for a new CHOP CoE devoted to advancing the science of quality measurement and participating effectively in the PQMP; (2) Enhance a core measure of pediatric healthcare quality-avoidance of inappropriate use of antimicrobial therapy for otitis media with effusion-by adapting it for electronic health records; (3) Develop and validate pediatric readmission outcome measures including a traditional readmission measure based on information obtained on admission and a new readmission measure based on information collected at discharge, with the intent of assessing outpatient care related to readmissions; (4) Develop and validate the duration and stability of child health insurance coverage measures; (5) Enhance the developmental screening core measure by adapting it for EHRs and linking screening data from primary care to receipt of community-based early intervention services; and, (6) Develop a Multivariate Matching Lab and apply matching methods to risk adjustment, disparity assessment, and metric validation. The CHOP CoE will collaborate with several children's hospitals in the Pediatric EHR Data Sharing Network (PEDSNet) and the GE Healthcare Medical Quality Improvement Consortium multi-practice data warehouse of over 15 million electronic health records. Stakeholder alliances with State Medicaid Directors, Independence Blue Cross of Pennsylvania, clinicians, families, and others, will provide substantive input on the applicability and importance of all proposed metrics. In summary, with the expertise, data, infrastructure, and alliances that are necessary to be successful, the CHOP CoE proposal is highly responsive to the requirements of the U18 RFA-HS-11-001 and should provide unique value to the PQMP. PUBLIC HEALTH RELEVANCE: The Children's Hospital of Philadelphia is proposing to be a Center of Excellence for the Pediatric Quality Measures Program (PQMP). Our unique methodological competencies are using the EHR to measure quality, development of innovative quality and outcome measures, and statistical methods for risk adjustment and disparity assessment. Based on our extensive experience with outcome and process measure development, we have suggested a coherent plan for quality measure enhancement and development that we believe will benefit the entire PQMP consortium, and help guarantee that the metrics developed from this ambitious initiative will be of the highest caliber and of adequate scale and scope to transform child health.