Health Services Research Supports Learning Health Systems
The Health Services Research Matrix at Cincinnati Children’s links researchers, patients and clinicians to improve care and outcomes for children, families, and communities. An integral part of the HSR Matrix is to support learning health systems to help patients and providers work together to choose care based on evidence. One such learning health system is the Ohio Perinatal Quality Collaborative (OPQC), a statewide network dedicated to improving perinatal health and reducing reduce preterm births. Since 2008, the OPQC’s focus on reducing elective scheduled deliveries before 39 weeks has prevented an estimated 950 NICU admissions; avoiding about $19 million in unnecessary costs. We also support the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a national group of experts who collaborate on improved management of juvenile idiopathic arthritis. PR-COIN has created a shared decision making tool for providers, patients, and parents.
Shared Decision Making Delivers Evidence-Based, Family-Centered Care
Shared decision making (SDM) has emerged as a best practice in situations where there are multiple medically reasonable options that differ in ways that matter to families. Clinicians share information about options and patients and parents share their goals, values and preferences. Together, a plan is developed to best fit the patient’s needs. Decision aids are evidence-based tools that improve patient/family knowledge, decrease their uncertainty, and improve alignment between their preferences and the treatment plan. While decision aids have grown in use in adult settings, their application has been limited in pediatrics.
William Brinkman, MD, MEd, MSc, a member of our Evidence and Measures Team, is leading efforts to support SDM throughout Cincinnati Children’s. Brinkman and colleagues recently published findings that show parents of children newly diagnosed with ADHD were better informed and more involved in decision making after receiving an SDM intervention. The intervention materials were developed in partnership with Professor Mike Zender and his graduate students at the University of Cincinnati College of Design, Architecture, Art, and Planning (DAAP). This study was funded by a CCHMC Place Outcomes Research Award.
Building on this success, Brinkman and colleagues have collaborated with investigators in more clinical settings. In Adolescent Medicine, Lea Widdice, MD, has employed a decision aid that has increased knowledge and support for receiving human papillomavirus vaccines. Meanwhile, Esi Morgan DeWitt, MD, MSCE, Ellen Lipstein, MD, MPH, and Carole Lannon, MD, MPH, collaborated to develop a successful decision aid for use in managing juvenile idiopathic arthritis. For more information about SDM tools, please visit: www.cincinnatichildrens.org/shareddecisions
Mentoring Program Supports Young Investigators
The HSR Matrix mentoring program promotes the career development of young investigators in health services research. Fifteen junior investigators from 13 pediatric, surgical and patient services divisions are currently in the program. Major outcomes measures for the program were developed in collaboration with mentors and mentees, the Office for Faculty Development and the Education and Learning group in Human Resources. Measures track on-time promotion, retention, success at meeting research goal, career satisfaction and feedback about the program. In FY 2013, the HSR Matrix hosted 12 speakers and two community learning events with national and international leaders addressing topics ranging from methodology to community building and innovative care strategies. Especially popular talks came from Bruce Marshall, MD, Vice President of Clinical Affairs at the Cystic Fibrosis Foundation and Mark Schuster, MD, PhD, Vice Chair for Health Policy at Boston Children’s Hospital.