Healthcare quality and process improvement research at CPCE aims to increase pediatric clinical effectiveness at The Children’s Hospital of Philadelphia and beyond. It is a unique field of scientific inquiry that requires multidisciplinary collaboration among experts trained in medicine, behavioral sciences, epidemiology, economics, and business processes.
Healthcare is profoundly human and personal, but it is important to view it as an industry so that its processes can be evaluated and improved. The Institute of Medicine has argued that the quality of health care in the United States falls short of biomedical knowledge and that this gap in quality is primarily a failure of organization, rather than of individual physicians. Thus, in addition to CPCE research on improving evidence-based medicine, we also work to develop better evidence-based management and organization that supports delivery of healthcare services.
Much of this research heavily leverages Health Information Technology (HIT) tools to improve and standardize the secure use and sharing of HIT and electronic health records (EHR) in pediatric medicine to improve clinical effectiveness.
As health systems move away from fee-for-service models to high-value-care models, data-driven decisions are required to improve “quality care” in the US. For this, the Institute of Medicine recommends research is needed around these quality care core components:
- patient safety
- treatment effectiveness
- patient-centered care
Areas of Research on Healthcare Quality and Process Improvement
Clinical Decision Support -- The goal of Clinical Decision Support (CDS) research at CPCE is to improve and standardize the quality of pediatric healthcare. Several recent projects have achieved this goal by using electronic tools to promote shared decision-making (SDM) processes for common pediatric conditions such as asthma and attention-deficit disorder (ADD). Other research seeks to help parents facing decisions related to advanced and palliative care.
Patient Medication Safety -- CPCE researchers focus on developing methods for and using large data sets from electronic health records to understand the safety and effectiveness of medication use in pediatric primary care. Recent areas of interest include psychotropic medication, asthma, and the management of hypertension.
Improving Processes of Care -- Quality in health care is a direct correlation between the level of improved health services and desired health outcomes. This research examines associations between dynamic aspects of workload, workforce, and quality of care at children’s hospitals primarily for the inpatient setting.
Treatment Adherence -- Patient adherence to recommended treatments is key to good health outcomes for pediatric patients. This area of research explores ways to measurably improve patient treatment adherence and outcomes using digital strategies such as social media and eHealth.
Cardiology Health Services Research -- Cardiology research at CPCE aims to improve the health and well-being of children with congenital and acquired heart disease. CPCE’s investigators perform studies using both large observational data sets and more traditional cohort studies to to develop metrics to measure programmatic quality in cardiology, develop novel methods to measure outcomes in cardiology, and apply patient- reported outcomes to measure health in children with cardiac disease.
Use of EHR and HIT in Healthcare -- CPCE is improving and standardizing the secure methods to use and share HIT and EHR data to develop evidence-based effective HIT interventions, such as expanding the capacity of the Pediatric Health Information System (PHIS) database to accurately and reliably include laboratory and radiology data, using EHR to collect performance measures in pediatric emergency and primary care settings, and to improve medication management through use of electronic decision support tools.
Implementation Science -- Implementation science is the use of strategies to adopt and integrate evidence-based health interventions and change practice patterns within specific settings. CPCE research on implementation addresses the level to which health interventions can fit within real-world public health and clinical service systems. See research specific to HIT/EHR implementation science.