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）的一项提案，旨在成为儿科质量措施计划（PQMP）卓越中心（CoE）网络的一部分。CHOP已经为新的卓越中心建立了一个组织架构，该架构建立在现有的强大基础设施之上，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泛和深入的领导力和方法专业知识的调查人员。卓越中心将包括五个方法学核心：（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）多变量匹配实验室-该实验室将提供独特的分析能力，增强传统的分析方法，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异，并改进新质量指标的验证;（3）医院计量-制定关注住院质量的指标;（4）医疗之家-衡量医疗之家和与其相连的社区服务的绩效;以及（5）健康计划-特别强调计划登记持续时间和稳定性的衡量。该提案有6个具体目标：（1）形成一个新的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）通过将其适用于电子健康记录，加强儿科医疗保健质量的核心测量-避免对渗出性中耳炎不适当使用抗菌药物治疗;（3）开发和验证儿科再入院结局指标，包括基于入院时获得的信息的传统再入院指标和基于出院时收集的信息的新再入院指标，目的是评估与再入院相关的门诊护理;（4）制订和验证儿童健康保险覆盖措施的持续时间和稳定性;（5）加强发展筛查核心措施，使其适用于电子健康记录，并将初级保健的筛查数据与接受社区早期干预服务联系起来;（6）建立多元匹配实验室，并将匹配方法应用于风险调整、差异评估和指标验证。CHOP CoE将与儿科EHR数据共享网络（PEDSNet）中的几家儿童医院以及GE Healthcare医疗质量改进联盟（GE Healthcare Medical Quality Improvement Consortium）合作，该联盟拥有超过1500万份电子健康记录的多实践数据仓库。与州医疗补助主任、宾夕法尼亚州独立蓝十字、临床医生、家庭和其他利益相关者的联盟将为所有拟议指标的适用性和重要性提供实质性投入。总之，凭借成功所需的专业知识、数据、基础设施和联盟，CHOP卓越中心提案高度响应U18 RFA-HS-11-001的要求，并应为PQMP提供独特的价值。

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.