We aim to establish a pediatric Center for Education and Research on Therapeutics (CERTs) Research Center (RC) with the theme of improving care and outcomes for children by optimizing the use of therapeutics. Subthemes are quality and safety. With a core infrastructure at Cincinnati Children's Hospital Medical Center (CCHMC) and regional and national partnerships to enhance spread and translation into practice and policy, significant innovations in patient safety, comparative effectiveness and improvements in care can be achieved. Five projects are planned: 1) Reduce unsafe ICU transfers and the need for therapeutic interventions by using situation awareness, a high reliability strategy;2) Predict and prevent acute kidney injury in hospitalized children receiving nephrotoxic medications by testing, refining, and spreading a trigger tool and mitigation intervention;3) Compare the effectiveness of antibiotics for the most common serious bacterial infection in children, community acquired pneumonia, using a health system population database;4) Evaluate diffusion and implementation strategies to prevent prematurity and related lung problems by using antenatal corticosteroids and 17-hydroxyprogesterone, in a statewide perinatal network;and 5) Ensure safe use of disease-modifying anti-rheumatic drugs, and develop a shared decision-making tool, in a pediatric network for the 6th most common cause of childhood disease, arthritis. We will use CCHMC and Learning Networks (multi-site collaborations of patients/families, clinicians, and researchers) as the innovation engines and laboratories that can help standardize care so that new approaches can be evaluated effectively and efficiently to improve therapeutic care and health outcomes for children. In addition, we propose activities that explore planned experimentation in complex health systems, and the ethics and data sharing policies needed to enable large registry studies.

Public Health Relevance

Children have unique needs, types and severity of illness that create special challenges for pediatric therapeutics. Their care is suboptimal. This CERTs will focus on translating research into practice to improve quality and safety so that every child gets the right therapeutic at the right time in the right way--every time.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Program--Cooperative Agreements (U19)
Project #
1U19HS021114-01
Application #
8265042
Study Section
Special Emphasis Panel (ZHS1-HSR-X (03))
Program Officer
Bartman, Barbara
Project Start
2011-09-30
Project End
2016-08-31
Budget Start
2011-09-30
Budget End
2012-08-31
Support Year
1
Fiscal Year
2011
Total Cost
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Favier, Leslie A; Taylor, Janalee; Loiselle Rich, Kristin et al. (2018) Barriers to Adherence in Juvenile Idiopathic Arthritis: A Multicenter Collaborative Experience and Preliminary Results. J Rheumatol 45:690-696
Reed, Julie E; Kaplan, Heather C; Ismail, Sharif A (2018) A new typology for understanding context: qualitative exploration of the model for understanding success in quality (MUSIQ). BMC Health Serv Res 18:584
Harris, Julia G; Bingham, Catherine A; Morgan, Esi M (2016) Improving care delivery and outcomes in pediatric rheumatic diseases. Curr Opin Rheumatol 28:110-6
Brown, David W; Mangeot, Colleen; Anderson, Jeffrey B et al. (2016) Digoxin Use Is Associated With Reduced Interstage Mortality in Patients With No History of Arrhythmia After Stage I Palliation for Single Ventricle Heart Disease. J Am Heart Assoc 5:
Downes, Kevin J; Goldstein, Stuart L; Vinks, Alexander A (2016) Increased Vancomycin Exposure and Nephrotoxicity in Children: Therapeutic Does Not Mean Safe. J Pediatric Infect Dis Soc 5:65-7
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Brady, Patrick W; Zix, Julie; Brilli, Richard et al. (2015) Developing and evaluating the success of a family activated medical emergency team: a quality improvement report. BMJ Qual Saf 24:203-11
Crosby, Lori E; Shook, Lisa M; Ware, Russell E et al. (2015) Shared decision making for hydroxyurea treatment initiation in children with sickle cell anemia. Pediatr Blood Cancer 62:184-185
Goldstein, Stuart L (2015) Automated/integrated real-time clinical decision support in acute kidney injury. Curr Opin Crit Care 21:485-9
Downes, Kevin J; Patil, Neha R; Rao, Marepalli B et al. (2015) Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis. Pediatr Nephrol 30:1879-88

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