Cerebral Palsy Research Network Blog

Archive for Quality Improvement

CPRN Turns Five!

The Cerebral Palsy Research Network (CPRN), founded in the summer of 2015, has reached its fifth anniversary. Born out of a 2014 workshop organized by the National Institutes of Health (NIH) and first designed to achieve a national registry for cerebral palsy (CP), CPRN has emerged as a multi-focus initiative and one that has given rise to a lasting partnership between the community and clinician researchers to improve outcomes for people with CP.

A 5-year strategic plan created in 2016 led to the realization of the following major milestones:

  • Engagement of community, clinical and research stakeholders to set and prioritize a patient-centered research agenda. The engagement was accomplished through the establishment of a Community Advisory Committee and the execution of two patient-centered research setting initiatives called Research CP, the first of which was funded by the Patient Centered Outcomes Research Institute (PCORI). This research agenda guides CPRN’s research focus and is influenced, dynamically, via ongoing community engagement in MyCP.org which was launched in the spring of 2019.  MyCP.org is a web portal that provides the community with opportunities to engage in CP research by participating in surveys and/or discussions with clinicians and researchers.
  • Establishment of registry infrastructure to accelerate CP research. This infrastructure includes two registries: a clinical CP registry and a community CP registry. The clinical registry includes data from more than 4,000 patients from 17 enrolling centers and will grow as more of the 28 centers committed to hosting the registry contribute their patient data. The community registry, where community members register themselves and contribute their data and perspectives on CP, launched in 2019 with the inaugural annual survey of adults with CP.
  • Facilitation of multidisciplinary research collaboration. Clinician researchers from multiple disciplines and multiple centers are tackling pressing and patient-centered research questions and quality improvement initiatives designed to improve outcomes for persons with CP. CPRN has submitted multiple grants and has received funding from NIH, PCORI, non-governmental organizations and private foundations for projects such as studying epilepsy in CP, genetics in CP and speech and language predictors of participation in CP. CPRN has also internally funded five quality improvement initiatives: adult care, dystonia, hip health, intrathecal pump infections, and care transitions, all of which seek to rapidly change clinical processes to improve outcomes for persons with CP.

The next five years promise new centers joining CPRN, more data collection and contribution from existing centers, and the development of many new patient-centered research and quality improvement initiatives. The anticipated growth will advance our development as a Learning Health Network that continuously improves treatments and outcomes for CP through research and quality improvement. Our focus over the next five years will give us more ways to engage the CP community and enhance outcomes locally, nationally and internationally.

CPRN Seeks to Translate Knowledge Broadly

The Cerebral Palsy Research Network (CPRN) decided to increase its investment in knowledge translation following its annual investigator last week. For CPRN, to “translate knowledge broadly” means to reduce practice variation by implementing best practices and evidence-based medicine across the 26 sites in its network. Reducing practice variation has been demonstrated to improve outcomes which is central to the mission of CPRN. By tackling this in a whole network fashion, CPRN expects to improve outcomes for a broad population of people with cerebral palsy (CP) in North America.

CPRN held a modified version of its annual investigator meeting last week. Originally planned to be an in-person meeting of more than 40 investigators prior to the COVID-19 pandemic, last week’s meeting was attended by more than 50 investigators from more than 30 institutions via Zoom. Review of CPRN’s five-year strategic plan highlighted the need to invest more in knowledge translation. CPRN will pursue transforming its network into a learning health network – an established model for rapidly improving health care outcomes for a variety of diseases and conditions.

Peter Margolis, MD, PhD

Peter Margolis, MD, PhD

CPRN hosted Peter Margolis, MD, PhD from Cincinnati Children’s Hospital as a guest speaker and an expert on building Learning Health Networks. His presentation sparked an enthusiastic dialogue amongst investigators to establish new quality improvement initiatives including adult care for CP, hip surveillance and dystonia in addition to our existing initiative for intrathecal baclofen pumps. CPRN’s adult care initiative, led by CPRN Exec Committee member Ed Hurvitz, MD, has already begun planning the new initiative to improve treatments and outcomes adults with CP.  The other initiatives will establish leaders and working teams in the coming weeks.  CPRN expects its increased investment in quality improvement initiatives will build on its cerebral palsy registry, complement its research efforts and accelerate the improvement in outcomes for people with CP.

2020 Vision

The Cerebral Palsy Research Network (CPRN) is approaching its fifth anniversary. Our strategic plan, which was finalized in early 2016, was intended to go through 2020. As we look back, we find that our strategic plan has been a “North Star”, and we have made great progress. 

We originally defined three strategic initiatives:

  1. Foster and conduct high-quality, multi-center multi-discipline quality initiatives and clinical research on cerebral palsy.
  2. Sustain a world-class multi-center and patient-centered clinical research organization.
  3. Translate knowledge broadly.

In 2019 we heard from numerous sites that they wanted to participate in our registry with a focus on conducting high quality research and quality improvement.  We added Benioff Children’s Hospital Oakland, Children’s Mercy Hospital in Kansas City and Joe DiMaggio Children’s Hospital in Hollywood Florida. These additional sites strengthen the network’s reach and further diversify our registry footprint.  We also published our CPRN Registry Elements data dictionary and data transfer specification to further standardize and accelerate our data collection for our CP registry. Enthusiasm to join the network continues to be strong with nine additional sites on track to join in the near future. 

To accomplish our second strategic initiative, we established a fiscal structure for CPRN to receive ongoing grant support and participation fees to sustain our work.  Our standard operating procedures outlined in a manual that describes how we function as a network, were put to work for the review of study applications and additional manuscripts.  And our Community Advisory Committee, which is essential to keeping our work patient-centered, helped shape our research strategy by guiding us to launch two important efforts in 2019 in health care transition for CP and dystonia in CP.

Our research and quality initiatives continue to grow and take shape.  Our annual investigator meeting was hosted by the University of Michigan in May 2019. It was a high energy and focused advancement of current and future research projects.  We launched our Community Registry and MyCerebralPalsy.org – a consumer facing web portal with a forum, news and opportunities to participate in research — with our first study of adults with cerebral palsy focused on well-being and pain. And this year our registry data led to several presentations and posters featured at the annual meeting of the American Academy for Cerebral Palsy and Developmental Medicine.

Our network approved four new research concepts from investigators pursuing grant applications that leverage CPRN. These topics included:

  • two on spasticity management strategies,
  • therapy dosing, and
  • the role of body composition.

Our partner CP NOW has committed to funding research that advances the Research CP priorities and leverages the use of CPRN’s resources. This study focuses on the role of speech in participation for children with CP. 

We ended the year with our second publication entitled “The Role of Registries in Cerebral Palsy Research” and we received pre-approval from the National Institutes of Health to submit a multi-center $14M study of spasticity interventions in early 2020!

Our research initiatives and infrastructure will continue to advance in 2020 as we turn to planning the next phase of CPRN’s growth and impact.  Our third strategic initiative is the most exciting as it is where CPRN can begin to measure its impact on outcomes for people with CP as we seek to “translate knowledge broadly.”  Translating means not just publishing results but also putting the tools and techniques into practice in the hospital and community settings. We have established a very broad infrastructure that will allow network sites to implement evidence-based medicine and quality improvement initiatives in the CP clinics at CPRN centers.  The CPRN registry will allow us to measure implementation AND track patient outcomes so that we can begin to achieve our mission of improving outcomes for people with CP.

We enter 2020 excited about our vision for the future and energized to make it happen!