Detecting and Understanding Disparities in Pediatric Safety Events for Hospitalized Children

检测和了解住院儿童儿科安全事件的差异

• 批准号: 10661525
• 负责人: Kavita Parikh
• 金额: $ 5.75万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-07 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10661525
• 关键词: Detecting; Understanding; Disparities; Pediatric; Safety

Project Summary/Abstract: Despite decades of focus on reducing medical errors, children continue to suffer substantial harms in hospital settings, and pediatric safety events in hospitals disproportionately affect children of color and those who live in poverty. While there has been work in pediatrics to categorize and address safety events, there is a critical need in our understanding and approaches to eliminate racialized and socio- economic disparities in pediatric safety events. The long-term goal is to ensure equitable care for all hospitalized children. The overall objectives are to leverage existing pediatric safety measures to detect and understand drivers of disparities in select inpatient pediatric safety events. The Chin framework for advancing health equity in patient safety, which is informed by patient and family engagement, will be used, and consists of identifying health disparities, understanding potential mechanisms that drive them, and then designing interventions to eliminate disparities. In direct response to Agency for Healthcare Research and Quality’s (AHRQ) recently released Special Emphasis Notice “Interest in Health Services Research to Advance Health Equity” NOT-HS-21-041, a mixed-methods study to advance the nation’s goal of achieving equity in the delivery of healthcare services by reducing disparities in select pediatric patient safety events is proposed through these two specific aims: 1). Detect disparities in pediatric safety events among hospitalized children by race/ethnicity and/or socioeconomic status. Pediatric safety outcomes will include the AHRQ pediatric quality indicators (PDIs) and adverse medical device event (AMDE) rates in pediatric hospitalizations. Both the Kids’ Inpatient Database and Inpatient Essentials database will be evaluated for disparities in PDIs or ADMEs. 2). Understand mechanisms and identify potential interventions for eliminating racialized and socio-economic disparities in pediatric safety events. Selected pediatric safety events will be identified and in-depth, qualitative analysis via focus groups of hospital staff/clinicians and patients/families will be conducted to identify potential mechanisms of disparities and interventions to address these disparities. This aim will be informed by Flores and Ngui’s comprehensive, patient-and-family centered framework for understanding disparities in pediatric safety events. The research proposed in this application is innovative because the disparities in pediatric safety events will be analyzed using established measures of pediatric safety combined with patient/family engagement to comprehensively understand potential drivers of selected measures. The proposed research is significant because it is expected to provide a more detailed understanding of select disparities in pediatric safety events and identification of potential interventions to address these disparities. These results are expected to have profound positive impact by identifying patient-family centered candidate interventions for addressing specific disparities in pediatric safety for future R01 study. This proposal aligns with AHRQ’s goals and priority population of improving health care quality, safety, and equity in children.

项目摘要/摘要：尽管几十年来专注于减少医疗错误，但儿童仍在遭受痛苦 医院环境中的重大危害和医院的小儿安全事件对儿童的影响不成比例 颜色和生活在贫困中的人。虽然有儿科工作以分类和解决 安全事件，我们的理解和方法迫切需要消除种族化和社会化的方法 小儿安全事件中的经济差异。长期目标是确保所有人的公平护理 住院的孩子。总体目标是利用现有的儿科安全措施来检测和 了解某些住院儿科安全事件中差异的驱动因素。下巴前进的框架 将使用患者和家庭参与的患者安全中的健康平等，并将使用，并组成 确定健康差异，了解推动它们的潜在机制，然后设计 消除差距的干预措施。直接回应医疗研究和质量机构 （AHRQ）最近发布了特别重点注意“对卫生服务研究的兴趣，以促进健康 股权”非HS-21-041，这是一项混合方法研究，旨在促进国家实现公平目标的目标 提出了通过降低精选儿科患者安全事件中的差异来提供医疗服务的服务 通过这两个具体目标：1）。检测住院儿科安全事件的差异 儿童按种族/种族和/或社会经济地位。小儿安全结果将包括AHRQ 小儿住院治疗的小儿质量指标（PDI）和不良医疗设备事件（AMDE）。 孩子的住院数据库和住院必需品数据库都将评估PDI或PDI的差异 amed。 2）。了解机制并确定消除种族化的潜在干预措施 小儿安全事件中的社会经济差异。将确定选定的儿科安全事件，并 深入的，将通过医院工作人员/临床医生和患者/家庭的焦点小组进行定性分析 确定分布和干预措施的潜在机制，以解决这些分布。这个目标将是 由Flores和NGui的全面，患者和家庭的框架所告知，以理解 小儿安全事件的差异。本应用程序中提出的研究具有创新性，因为 小儿安全事件的差异将使用已建立的小儿安全措施进行分析 通过患者/家庭参与，可以全面了解所选措施的潜在驱动因素。这 拟议的研究很重要，因为它有望提供对精选的更详细的理解 小儿安全事件的差异以及确定解决这些分布的潜在干预措施。 预计这些结果将通过识别患者与患者的候选人产生深远的积极影响 用于解决未来R01研究的小儿安全性特定分布的干预措施。该提议保持一致 AHRQ的目标和优先人口，以提高儿童的医疗保健质量，安全性和公平性。