Network News Excerpts
(EXCERPTS TAKEN FROM THE SUMMER 1998
EDITION OF THE NETWORK NEWS)
From the Director
By Mort Wasserman, MD, MPH
The Origin of PROS Projects or,
Whose Network Is This, Anyway?
In what sense does PROS belong
to PROS practitioners? I've been pondering this question recently in
light of the three PROS projects that are in, or about to begin, data
collection.
The Polio Immunization Delivery
Study (PIDS), a collaboration between PROS, the CDC, and the Pediatric
Section of the National Medical Association, examines the extent to
which a major immunization policy change (the sequential IPV/OPV schedule,
with its additional injections of young infants) could result in an
unintended consequence - lower immunization or health supervision rates.
This is an important question for pediatric practitioners, and one that
many policy makers want answered. Quite frankly, however, this research
question did not come to PROS from PROS practitioners, but from officials
with the National Immunization Program.
The Helping Improve Pediatric Practice
Outcomes (HIPPO) asthma study is an attempt to evaluate whether pediatric
practitioners in geographically dispersed and structurally diverse practices
can work together (if at a distance) with quality improvement consultants
to better the care of patients in their offices - in this case, patients
with chronic asthma. This is an important practical question, as many
experts feel that the largest gap in health care is no longer between
what we know and don't know about the care of patients, but between
what we know and what we do. Although practitioners who deliver care
in institutional settings often have quality improvement programs to
help them, most practitioners don't practice in such settings, and care
improvement efforts in scattered community practices have rarely been
undertaken, much less evaluated. This is an important area for pediatricians,
but in all honesty, this research question didn't originate with PROS
practitioners, but rather from the PROS leadership in consultation with
the Packard Foundation and pediatricians at the forefront of pediatric
quality improvement.
So, whose network is this, anyway?
Doesn't PROS conduct research based on ideas from its own members? The
answer is a re-sounding, "Yes!" The Secondary Sexual Characteristics
Study and the recently completed Febrile Infant Study certainly arose
from the PROS membership. And this fall PROS will begin the Life Around
Newborn Discharge (LAND) study, which has recently been funded by Health
Resources and Services Administration the Maternal and Child Health
Bureau. The LAND study arose with a group of PROS practitioners who
were outraged, several years ago, over insurance companies' attempts
to force the discharge of newborns and mothers from hospital in less
than 24 hours. The study idea, which began with a focus on length-of-stay,
evolved with practitioner input to examine newborn discharge decision-making,
its relation to other newborn support services, and their combined
effect on outcomes in the newborn period. The LAND study represents
an idea that "bubbled up" from the trenches and will now be executed
by PROS.
And so, my answer to the question
"Whose network is this, anyway?" is - "PROS practitioners." Not all
ideas originate from PROS practitioners, but practitioners (via their
Chapter Coordinators, PROS-Net, network surveys, etc.) put their stamp
on each project. And on a regular basis, PROS conducts projects based
on ideas that originate from PROS practitioners. PROS belongs to you.
From The Steering Committee
Chair
By Gordon Glade, MD
In May I was able to attend the
annual meeting of the Pediatric Academic Societies (PAS). I now know
that these societies include the Ambulatory Pediatric Association (APA),
the Society for Pediatric Research (SPR) and the American Pediatric
Society (APS). Myriad other abbreviations made reading the meeting program
daunting, but once I got past the program registration and into the
meetings, I was enlightened and remain enthusiastic about what I observed.
Thousands of pediatric practitioners
were exchanging information learned from thousands of research projects.
I sensed an energy and curiosity that was unfamiliar to me at such a
big meeting. As a practitioner I had to wonder "So what?" as I looked
at posters on obscure metabolic mediators in mice. I also wondered at
just what creates this hunger for data--true thirst for knowledge, grant
money, tenure? As a practicing pediatrician not burdened by the "publish
or perish" cloud, I loved gleaning as much information as possible.
I couldn't move fast enough to hear and see and process research that
could improve the way I practice pediatrics.
PROS was a recognized player at
this meeting with about a dozen presentations in various forums. There
is an APA Special Interest Group (SIG) devoted to practice-based research
networks which recognizes the important part that PROS plays in PBRNs.
As I visited with pediatricians from all over, I was pleased to learn
that everyone knows about PROS and recognizes the important role PROS
has in answering certain questions about the health and health care
of children.
Thanks to PROS I was able to present
an abstract about the use of the phone in our PROS referral study. What
really excited me was the feedback that people gave about how important
they believe this and other PROS studies are. I was proud.
As PROS becomes better known, more
people are looking to PROS to do studies. Some recognize the value of
the list of PROS practitioners and want to use that list to do studies
of their own. At least three have approached PROS just in the past few
months for a list of PROS practices that they might contact to do a
study. As chairman of the steering committee I would like to ask you
your opinion as to what to do.
About seven years ago, a colleague
approached the PROS steering committee to ask if the APA could use the
PROS membership directory to recruit new members for the APA. I strongly
objected, feeling that we did not have the right to give out that information
without the practitioners' permission. I am personally enthusiastic
about the APA now, but realize that that enthusiasm was achieved through
a personal experience, not a mass mailing. Again I wonder what you would
like PROS to do.
At the end of this newsletter there
is a section called PROS Practitioner Feedback where you can return
comments about who should have access to our PROS membership directory.
Please fill it out. If it is more convenient, respond through PROS-NET
or directly to myself at glgglade@ihc.com or to Mort at rwasserm@zoo.uvm.edu.
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