Developing Clinical Benchmarks and Quality Indicators forLate Preterm Infants During the Birth Hospitalization

PROJECT ABSTRACT The candidate, Neha S Joshi, MD MS, is a physician scientist and neonatal hospitalist who seeks to identify clinical benchmarks and quality markers for late preterm infants during the birth hospitalization. Dr. Joshi is seeking a K23 award to become an expert independent investigator in the identification of high value care practices for newborn care. Late preterm infants comprise of 280,000 infants born in the United States annually. Approximately 40% of these infants require NICU care, though considerable variability exists amongst institutions for their clinical management and admission location. This variability likely comes at both a financial cost, in addition to the patient-level cost of separation of the mother-infant dyad and its associated risks including breastfeeding and bonding. In order to minimize variability and optimize care for late preterm infants, Dr. Joshi is proposing the following Aims: Aim 1: Evaluate current clinical morbidities and medical intervention rates in management of late preterm infants during the birth hospitalization. Aim 2: Test the association of institutional structural variables with late preterm care outcomes all California births. Aim 3: Develop process measures/clinical benchmarks, structural measures, and outcome measures for late preterm infants. Dr. Joshi will leverage the strengths of two large research networks – the California Perinatal Quality Care Collaborative and the Better Outcomes through Research for Newborns Network – to help achieve these aims. Dr. Joshi is mentored by exceptional leaders in research networks for well newborn and NICU care, health services research, perinatal outcomes research, implementation science, and the clinical care of late preterm infants. Their directed mentorship, a robust training plan, and proposed research aims will complement her prior training in Pediatric Hospital Medicine and Clinical Research and Epidemiology. Career development activities include a training plan focused on leveraging large academic datasets for research, development of quality care indicators, advanced principles in implementation science, and scientific/grant writing and scholarship dissemination. Dr. Joshi will benefit from the world-class research and clinical environment, and renowned expertise at Stanford University. At the conclusion of this award, Dr. Joshi will be optimally positioned to establish and lead implementation efforts and quality measurement for late preterm infants and well newborn care.