@article{0bacf9d6de5a459e8b09865ff57650ac,
title = "Quality improvement research in pediatric hospital medicine and the role of the Pediatric Research in Inpatient Settings (PRIS) network",
abstract = "Pediatric hospitalists care for many hospitalized children in community and academic settings, and they must partner with administrators, other inpatient care providers, and researchers to assure the reliable delivery of high-quality, safe, evidence-based, and cost-effective care within the complex inpatient setting. Paralleling the growth of the field of pediatric hospital medicine is the realization that innovations are needed to address some of the most common clinical questions. Some of the unique challenges facing pediatric hospitalists include the lack of evidence for treating common conditions, children with chronic complex conditions, compressed time frame for admissions, and the variety of settings in which hospitalists practice. Most pediatric hospitalists are engaged in some kind of quality improvement (QI) work as hospitals provide many opportunities for QI activity and innovation. There are multiple national efforts in the pediatric hospital medicine community to improve quality, including the Children's Hospital Association (CHA) collaboratives and the Value in Pediatrics Network (VIP). Pediatric hospitalists are also challenged by the differences between QI and QI research; understanding that while improving local care is important, to provide consistent quality care to children we must study single-center and multicenter QI efforts by designing, developing, and evaluating interventions in a rigorous manner, and examine how systems variations impact implementation. The Pediatric Research in Inpatient Setting (PRIS) network is a leader in QI research and has several ongoing projects. The Prioritization project and Pediatric Health Information System Plus (PHIS+) have used administrative data to study variations in care, and the IIPE-PRIS Accelerating Safe Sign-outs (I-PASS) study highlights the potential for innovative QI research methods to improve care and clinical training. We address the importance, current state, accomplishments, and challenges of QI and QI research in pediatric hospital medicine; define the role of the PRIS Network in QI research; describe an exemplary QI research project, the I-PASS Study; address challenges for funding, training and mentorship, and publication; and identify future directions for QI research in pediatric hospital medicine.",
keywords = "hospital medicine, hospitalists, implementation, pediatric, quality improvement, research networks",
author = "Simon, {Tamara D.} and Starmer, {Amy J.} and Conway, {Patrick H.} and Landrigan, {Christopher P.} and Shah, {Samir S.} and Shen, {Mark W.} and Sectish, {Theodore C.} and Spector, {Nancy D.} and Tieder, {Joel S.} and Rajendu Srivastava and Willis, {Leah E.} and Wilson, {Karen M.}",
note = "Funding Information: The authors would like to acknowledge the PRIS Network, a collaborative hospitalist research network sponsored by the Children{\textquoteright}s Hospital Association (CHA), Academic Pediatric Association (APA), American Academy of Pediatrics (AAP), and the Society of Hospital Medicine (SHM). Details are available online ( http://www.prisnetwork.org ). The Prioritization Project is funded by a grant from the CHA and from the Health Research Formula Grant 4100050891 from the Pennsylvania Department of Public Health Commonwealth Universal Research Enhancement Program . PHIS+ is funded by grant 1R01HSO986201 from the Agency for the Health Care Research and Quality (AHRQ) . The I-PASS Study is primarily funded through a grant from the US Department of Health and Human Services , Office of the Assistant Secretary for Planning and Evaluation, grant 1R18AE000023-01 . Additional funding for I-PASS has been provided by the Medical Research Foundation of Oregon , AHRQ ( 1K12HS019456-01 ), the Physicians{\textquoteright} Services Incorporated Foundation in Canada, and Pfizer{\textquoteright}s Medical Education Grant Program. IIPE is the Initiative for Innovation in Pediatric Education and is the entity that recognizes innovative educational proposals for pediatric residency training programs. More can be found at their Web site ( http://www.innovatepedsgme.org ). Funding Information: Financial Disclosures: The Pediatric Research in Inpatient Setting Network Executive Council members (CPL, SSS, TDS, RS, JST, KMW) and staff (LEW) are supported in part for their work on behalf of PRIS by a grant from the CHA. TDS is supported by Award K23NS062900 from the National Institute of Neurological Disorders And Stroke and Seattle Children{\textquoteright}s Center for Clinical and Translational Research and CTSA Grant Number ULI RR025014 from the National Center for Research Resources (NCRR), a component of the NIH. AJS is supported in part by an institutional K12 award from Oregon Health and Science University and the, grant 1K12HS019456-01. None of the sponsors participated in design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. Its contents represent the views of the authors and are solely the responsibility of the authors; they do not necessarily represent the opinion, policies, or official view of their respective institutions or the NCRR or NIH. Funding Information: The third PRIS study, IIPE-PRIS Accelerating Safe Sign-outs (I-PASS), is primarily funded through the US Department of Health and Human Services and the National Institutes of Health (NIH). 25,26 The extraordinary efforts by the I-PASS study and implementation teams has helped the PRIS Network understand the effort required to systematically disseminate and implement a rigorous complex intervention in varied settings and still ensure fidelity to a rigorous study design targeting patient outcomes. Funding Information: Publication of this article was supported by the Agency for Healthcare Research and Quality and the American Board of Pediatrics Foundation. Funding Information: The second PRIS study, Pediatric Health Information System Plus (PHIS+), is funded by the Agency for Healthcare Research and Quality (AHRQ). 24 The PHIS+ project links the clinical data (including laboratory, microbiology, and radiology data) from 6 children{\textquoteright}s hospitals that already submit administrative data to CHA{\textquoteright}s PHIS database. The primary purpose of PHIS+ is to conduct pediatric comparative effectiveness research studies using clinical data. However, the potential for QI research is equally relevant, as interventions that rely on aspects of a patient{\textquoteright}s course will be able to incorporate relevant data. ",
year = "2013",
month = nov,
doi = "10.1016/j.acap.2013.04.006",
language = "English (US)",
volume = "13",
pages = "S54--S60",
journal = "Academic Pediatrics",
issn = "1876-2859",
publisher = "Elsevier Inc.",
number = "6 SUPPL.",
}