Korst L, Kipke MD, Seri I, Fielding B, Goodwin TM; AcademyHealth. Meeting (2005 : Boston, Mass.).
Abstr AcademyHealth Meet. 2005; 22: abstract no. 4437.
USC Keck School of Medicine, Pediatrics, 4650 Sunset Boulevard, MS #30, Los Angeles, CA 90027 Tel. 323.671.7623 Fax 323.906.8043
RESEARCH OBJECTIVE: In 2003, Children's Hospital Los Angeles (CHLA) embarked on a 2 year Research Partnership with First 5 LA, a philanthropic organization committed to early childhood health and development programs for pregnant women and young children up to 5 years old. One arm of this Partnership addressed the feasibility of creating an inter-hospital clinical information system: 1) to link data from mothers and babies within hospitals; 2) to link these same data across hospitals; 3) to link these data among families, and therefore 4) generating longitudinal datasets to monitor health status and outcomes of at-risk mothers and children. STUDY DESIGN: Eight project milestones were defined and evaluated. The successful achievement of a milestone was judged on a five-point scale that was based on working through its critical incidents, or sticking points. POPULATION STUDIED: Our efforts began with LAC+USC Women's and Children's Hospital and CHLA, combining clinical and administrative hospital data from deliveries in 2002 and 2003 with data from newborns transferred to CHLA, thus tracking complete episodes of care for these children. We have begun efforts at a third local community hospital where we now have approval to add their patients, and where we will then track those newborns that are transferred to CHLA. PRINCIPAL FINDINGS: The 4 linkage objectives were achieved, although progress varied within each milestone: AGREEMENTS: Execute all key agreements (contracts and human subjects research proposals) within a timely manner. Score 3/5: Milestone achievement unrealistic, scaled back and achieved. DESIGN: Design a multi-hospital information system that can accomplish the data linkage Aims described above. Score 5/5: Achieve the letter and intention of the milestone. OPERATIONS: Provide smooth conduct of the project with respect to handling objectives, maintaining communications, anticipating timelines and working with budgets. Score 3/5: Milestone achievement unrealistic, scaled back and achieved. DEVELOPMENT: Create a working product Score 4/5: Achieved the milestone, but experienced critical incidents (got stuck)IMPLEMENTATION: Import all relevant data into the system, and/or install software as necessary for use at LAC and CHLA.Score 2/5: Strong progress toward milestone achieved EXPANSION: Implement the basic system in two additional hospitals. Score 2/5: Strong progress toward milestone achieved. GOVERNANCE: Develop a working organization to share data. Score 2/5: Strong progress toward milestone achieved.SUSTAINABILITY: Design and create a self-funding strategy. Score 2/5: Strong progress toward milestone achieved CONCLUSIONS: Although current policy structures are not optimal, data regarding individuals were aggregated from different sources, both within and across hospitals. Longitudinal data regarding high-risk families were also aggregated and tracked. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Critical incidents appear to be the rule within each milestone, and most of these incidents require attention, creativity, and resources to develop workarounds and get unstuck. The capacity to address these incidents varies across organizations.
Publication Types:
Keywords:
- Academic Medical Centers
- Achievement
- Child
- Child Health Services
- Communication
- Computer Systems
- Data Collection
- Female
- Health Services Research
- Health Status
- Hospital Information Systems
- Hospitals
- Hospitals, Community
- Humans
- Infant
- Infant, Newborn
- Los Angeles
- Mothers
- Organizations
- Pregnancy
- Program Evaluation
- Public Policy
- Research
- hsrmtgs
UI: 103623900
From Meeting Abstracts