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

描述（由申请人提供）：由于认识到医疗保健往往提供得很差、有缺陷、成本过高而没有效益，美国对医疗保健安全和质量的审查越来越多。在患者安全研究中，两个相互关联的临床领域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，通过多学科方法，包括定性研究方法、设计思想、模拟、对照试验和实施科学，来推进医疗保健安全科学。该项目将重点关注围产期护理的安全，重点关注分娩和分娩，这是美国最常见的住院原因。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，该项目不仅有可能有助于提高母亲和新生儿的安全和质量，而且还可能有助于保健中的一般安全科学。我们的建议也有可能对患者的治疗结果产生直接影响，因为研究的各个阶段都必须在患者护理环境中进行。在这个拟议的项目中，我们将开展以下工作：1)建立围产期安全学习实验室；2)开发和测试最佳新生儿复苏数据显示；3)开发和测试最佳产妇数据显示；4)开发识别和预防产妇临床恶化的流程；5)开发分娩和分娩套件的最佳物理设计。我们的安全学习实验室将开展四个相互关联的项目：项目#1：新生儿复苏的最佳交互式数据显示。项目2：为分娩和分娩提供最佳数据显示。项目3：提高对产妇临床恶化的认识；项目4：优化分娩套件的物理设计。我们将建立一个安全学习实验室，将产科、新生儿、护理学、设计专家、工程师和家长代表聚集在一起，扩大新生儿和孕产妇护理患者安全知识基础，并在四个项目中采用模拟方法开发、试点和测试创新设计。

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.