At least 44,000 patients die each year in the U.S. and numerous more are injured as a result of medical errors. Research by Dr. Thomas and one of his mentees shows that children comprise a significant proportion of these deaths and that 70,000 children are injured by care in hospitals each year. In addition to errors, pediatric healthcare is fraught with under use of effective care and over use of ineffective care. As Tom Boat notes in two important articles, research training in healthcare quality and safety should be central components ofthe pediatric research agenda in the United States. For 14 years Dr. Thomas has committed the majority of his time to research on healthcare quality and safety. He now has the experience and institutional environment to successfully mentor individuals who will dedicate their careers to conducting research to improve pediatric quality and safety. Dr. Thomas has a track record of mentoring, a national and international research reputation, and he holds key research training leadership roles at The University of Texas Medical School at Houston. Furthermore, UT Houston has an outstanding reseach training program fnded by a NIH CTSA grant, an AHRQ training grant for quality and safety, and Dr. Thomas directs the UT-Memorial Hermann Center for Healthcare Quality and Safety. Dr. Thomas expects to recruit two mentees per year for the first 2-3 years then mentor no more than 5 or 6 six mentees at a time. He will devote 25% effort to mentoring and 25% effort to the research plan outlined in this application. The research proposed for this award will test team training interventions to improve teamwork and the technical quality of neonatal resuscitation. Initial studies will be conducted in a simulator, followed by a two-center pilot study to assess the effect on the resuscitation of low birthweight infants. In addional, research wil be conducted on diagnostic errors, improving compliance with isolation of children with contagious diseases, developing quality measures for neonatal ICUs, measuring and improving safety culture, and improving care transitions fr-om the NICU to home and outpatient medical care.

Public Health Relevance

In the United States healthcare system children often suffer from medical errors, the overuse of Ineffective care, and underuse of effective care. This application seeks funding to support Dr. Thomas'time to serve as mentor for future leaders in the field of pediatric healthcare quality and safety. The studies proposed here, and those subsequently performed by Dr. Thomas'mentees, will generate new knowledge to improve tiediatric healthcare.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Pediatrics Subcommittee (CHHD)
Program Officer
Raju, Tonse N
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University of Texas Health Science Center Houston
Internal Medicine/Medicine
Schools of Medicine
United States
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Profit, Jochen; Kowalkowski, Marc A; Zupancic, John A F et al. (2014) Baby-MONITOR: a composite indicator of NICU quality. Pediatrics 134:74-82
Profit, Jochen; Etchegaray, Jason; Petersen, Laura A et al. (2012) The Safety Attitudes Questionnaire as a tool for benchmarking safety culture in the NICU. Arch Dis Child Fetal Neonatal Ed 97:F127-32
Profit, Jochen; Etchegaray, Jason; Petersen, Laura A et al. (2012) Neonatal intensive care unit safety culture varies widely. Arch Dis Child Fetal Neonatal Ed 97:F120-6