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Child Health Extramural Research by State and Country

Pennsylvania

Principal Investigator: Bell, Louis
Title: Creating a Primary Care Practice-Based Research Network
Institution: Children's Hospital of Philadelphia, PA
E-mail: belll@email.chop.edu
Project Dates: 09/30/02-09/29/04
Project No.: R21 HS13492
Summary: The Children's Hospital of Philadelphia network will develop an information system linking its pediatric practices and create a project committee to assess potential research questions aimed at improving the delivery of primary care to children and families.

Principal Investigator: Bell, Louis
Title: Electronic Health Record (EHR) Decision Support to Improve Outpatient Asthma Care
Institution: Children's Hospital of Philadelphia, PA
E-mail: bell@email.chop.edu
Project Dates: 01/02/06-12/31/07
Project No.: R21 HS14873
Summary: This intervention study will attempt to determine if an active clinical decision support (CDS) intervention imbedded in an EHR will improve adherence to National Asthma Education and Prevention Program (NAEPP) guidelines in the primary care setting. The intervention will offer a validated educational curriculum to primary care providers that stresses the evidence-based components of effective asthma care management and provides an asthma control and symptom assessment tool. The study is intended to ensure portability across institutions and EHR systems. This research will include urban and suburban children, ages 6 to 18 years, who make a clinic visit to one of 10 primary care pediatric sites during the study period and meet the criteria for persistent asthma.

Principal Investigator: Davis, Daniela H.
Title: Trends in the Non-Operative Management of Splenic Injury in Children.
Institution: Children's Hospital of Philadelphia, PA
E-mail: davisda@email.chop.edu
Project Dates: 04/01/01-06/30/02
Project No.: HRSA-240-97-0043
Summary: The purpose of this project is to characterize the diffusion of non-operative management of splenic injury in children within a regionalized trauma system.

Principal Investigator: Feudtner, John C.
Title: Profiling the Needs of Dying Children
Institution: Children's Hospital of Philadelphia, PA
E-mail: feudtner@email.chop.edu
Project Dates: 08/01/00-07/31/05
Project No.: K08 HS00002
Summary: This Mentored Clinical Scientist Award project includes research to determine whether the prevalence of terminal congenital complex chronic conditions is rising and to examine two markers of quality of care for children with complex chronic conditions: whether continuity of care deteriorates during the last two years of life and timing of referral to hospice.

Principal Investigator: Gorelick, Marc
Title: PEAT: Pediatric Emergency Assessment Tool
Institution: Jefferson Medical College, Philadelphia, PA
E-mail: mgorelick@nemours.org
Project Dates: 09/01/00-08/31/01
Project No.: R03 HS11028
Summary: This cohort study aims to develop a multivariable model to predict the probability of the need for different levels of emergency care. The model will use predictor information available at the time of patient triage.

Principal Investigator: Johnson, Thomas
Title: Enhancing Patient Safety Through a Universal EMR System*
Institution: DuBois Regional Medical Center, DuBois, PA
E-mail: thjohnson@drmc.org
Project Dates: 09/30/04-09/29/07
Project No.: UC1 HS015083
Summary: The aims of this project include: (1) implementing a universal electronic medical records (EMR) system across health care delivery sites in rural inpatient and outpatient settings, including a rural acute care hospital and its medical group and free clinic partners; and (2) use the EMR system to reduce cost of care delivery through improved productivity, lowered operating expenses, enhanced revenue, and improved regulatory compliance. The project further seeks to (3) use the EMR system to improve patient safety and reduce the frequency of medical errors; and (4) use the EMR system to improve quality of care for women, children, low-income uninsured populations, and patients receiving treatment for diabetes, congestive heart failure, and end-of-life care.

Principal Investigator: Linkin, Darren
Title: Communication Errors During Antibiotic Management Calls*
Institution: University of Pennsylvania, Philadelphia, PA
E-mail: linkin@mail.med.upenn.edu
Project Dates: 07/01/03-06/30/05
Project No.: F32 HS13982
Summary: The aim of this Predoctoral Fellowship Award is to perform a retrospective cohort study to determine the effect of inaccurate communication of patient data (from physicians caring for patients to the antimicrobial management programs [AMP] practitioners) on inappropriate antimicrobial recommendations. The quality of patient data recorded by the AMP practitioners will be judged compared to the patient medical record. The results of this study will be applied in a future intervention study, using clinical outcomes as an endpoint. Researchers expect a small proportion of the study patients to be children. Asian-Americans and African-Americans will be participants enrolled in this research.

Principal Investigator: Lorch, Scott
Title: Perinatal Regionalization and Quality of Care
Institution: Children's Hospital of Philadelphia, PA
E-mail: lorch@email.chop.edu
Project Dates: 09/30/06-09/29/09
Project No.: R01 HS15696
Summary: This study will (1) evaluate differences in the quality of neonatal care between hospitals; (2) determine the effect of perinatal deregionalization on rates of mortality, failure-to-rescue, complications, and 21-day readmissions in very low-birth-weight (VLBW) infants; and (3) develop a predictive model that explains neonatal outcomes as a function of the quality of neonatal care and regionalization policy in a given geographical area. This project will use population data from 1992 to 2002 in three states (California, New York, and Pennsylvania) that have an estimated 12,800 VLBW births per year. Racial and ethnic minority infants will be included in this study.

Principal Investigator: Nadkarni, Vinay
Title: Improving Patient Safety with Just-In-Time Pediatric Simulation Training
Institution: Children's Hospital of Philadelphia, PA
E-mail: nadkarni@email.chop.edu
Project Dates: 09/30/06-09/29/08
Project No.: U18 HS16678
Summary: This prospective study will randomize "sharp end" providers who manage airway emergencies in the pediatric ICU to either no overtraining or 20 minutes of either low-fidelity or high-fidelity simulation overtraining. Women and minorities will be included in this study.

Principal Investigator: Portnoy, Joel D.
Title: The Effect of Medication Errors in the Pediatric ICU
Institution: The Children's Hospital of Philadelphia, PA
E-mail: brtnoy@email.chop.edu
Project Dates: 09/04/01-08/31/06
Project No.: K08 HS11636
Summary: The aims of this Mentored Clinical Scientist Development Award are to: (1) calculate the increase in resource utilization attributable to exposure to medication errors in patients admitted to the pediatric ICU; (2) determine the risk of mortality attributable to exposure to medication errors in patients admitted to the pediatric ICU; and (3) determine the risk of requiring inpatient rehabilitation or technology dependence associated with exposure to medication errors.

Principal Investigator: Rosenquist, James
Title: Improving Public Health Policy for Adolescents
Institution: University of Pennsylvania, Philadelphia, PA
E-mail: jrosenqu@wharton.upenn.edu
Project Dates: 03/01/2005-11/30/2005
Project No.: R36 HS015561
Summary: This project will study the interrelationship between adolescent smoking and depression, as well as their impact on student performance. These issues are of great interest to policymakers, due to their longterm impact on public health. The study will use a unique panel dataset, developed by Georgetown University, which includes data on genetic markers for more than 1100 adolescents. Exploiting the endogenous variation in these markers and their predictive effect on adolescent smoking and health (depression) will facilitate answers to two main questions of interest: (1) Are current models of smoking demand and depression among youths biased when genetic variation among individuals is not taken into account?; and (2) What is the true impact of smoking status and depression on grade-point average (GPA) over time? Question 1 will compare estimators of smoking and depression with and without genetic markers, and Question 2 will use a 2-stage least squares estimator utilizing genetic variation as an instrumental variable. This project will include male and female minority (Hispanic, Asian or Pacific Islander, and African American) adolescents.

Principal Investigator: Silber, Jeffrey
Title: Conditional Length of Stay: A Pediatric Outcome Measure
Institution: Children's Hospital of Philadelphia, PA
E-mail: silberj@wharton.upenn.edu
Project Dates: 09/01/99-08/31/02
Project No.: R01 HS09983
Summary: This study will develop a new class of outcomes measures for quality of care measurement purposes for use in pediatrics. The construct validity of the measure will be demonstrated by defining the relationship between CLOS and other outcomes measures, such as death and complications.

Principal Investigator: Sirio, Carl
Title: Banner Health/Arizona State University Partnership for Emergency Department (ED) Patient Safety*
Institution: Enhanced Patient Safety Intervention to Optimize Medication Education (EPITOME), Pittsburgh, PA
E-mail: sirioca@ccm.upmc.edu
Project Dates: 07/01/05-06/30/07
Project No.: U18 HS15851
Summary: This project will evaluate the hospital-wide implementation of a multi-model patient medication education system referred to as EPITOME, and will assess the impact of and sustainability of EPITOME on patient safety outcomes. Moreover, the study will analyze the barriers to implementing EPITOME, while developing and evaluating strategies for overcoming those barriers in support of the program. As an additional component of the project, researchers will develop a tool-kit resource for promoting a generalizable and sustainable inpatient medication education process with which health systems and hospitals can encourage safer medication behaviors. Women, minorities (Hispanic or Latino, American Indian/Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and African American) and children will be included in this study.

Principal Investigator: Wald, Ellen
Title: A Pediatric PBRN (Pediatric PitNet) and a Pilot Project
Institution: Children's Hospital of Pittsburgh, PA
E-mail: walder@chp.edu
Project Dates: 09/30/02-09/29/04
Project No.: R21 HS13523
Summary: This new network of community and university-based pediatricians (Pediatric PitNet) will further develop its network infrastructure and conduct a pilot project to study methods of increasing adherence to recommendations for prevention of unintentional injuries, the most common cause of death and disability in young children.

Principal Investigator: Wald, Ellen
Title: Treatment of Children with Obesity in Primary Care
Institution: Children's Hospital of Pittsburgh, PA
E-mail: ellen.wald@chp.edu
Project Dates: 11/01/05-10/31/07
Project No.: R21 HS14862
Summary: This prospective, randomized, and controlled clinical trial will take place in 5 of 22 practices comprising the Pediatric PitNet, a PBRN servicing 130,000 children, and including 142 providers. The study will assess the effectiveness of teaching primary care providers to use specific communication strategies with the parents of overweight children to help them and their children take steps toward healthy behavioral changes. This trial will also offer core components of an efficacious family-based behavioral weight management program within the pediatric primary care setting to determine if participating children will change their behaviors regarding dietary intake and physical activity, enroute to a clinically meaningful weight loss. Racial and ethnic minority children between the ages of 9 and 12, with at least one parent, will be included in this study.

Principal Investigator: Wang, Henry
Title: Effect of Out-of-Hospital Endotracheal Intubation Errors*
Institution: University of Pittsburgh, PA
E-mail: wanghe@msx.upmc.edu
Project Dates: 04/01/04-03/31/09
Project No.: K08 HS013628
Summary: This Mentored Clinical Scientist Development Award will identify the patterns and effects of errors occurring in out-of-hospital endotracheal intubation (OOH-ETI) performed by paramedics. The aims of this study will (1) examine whether variations in the emergency medical services system structure, patient socioeconomic status or patient racial and ethnic background are associated with the incidence of out-of-hospital OOH-ETI) errors, and (2) determine whether OOH-ETI errors affect patient outcomes and in-hospital resource utilization. This study will involve patients of all ages (including children), both genders, and all ethnic groups.


*Project includes children or children's health care issues but does not focus exclusively on children.


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