Quality Corner: Fall 2019

October 24, 2019 by

By Dr. Jonathan Swanson

“The more things change, the more they remain the same.”  – Jean-Baptiste Alphonse Karr

The above quote seems to be apropos at this time – kids are back in school and getting into a routine, leaves are starting to change bringing fall and then winter. And of course, we have our Health System. Although many times this quote is said cynically, I think we can be proud of Children’s Hospital as we continue to provide the best, highest-quality care in Commonwealth even amidst all of the changes and stories swirling around us. As things change around us, we continue to provide the care that is needed.

In the last Kids Matters, we mentioned that the Children’s Hospital joined Solutions for Patient Safety, a network of nearly 150 children’s hospitals who “share the vision that no child will ever experience serious harm while we are trying to heal them.” Over the last several months, several team members and I have been hard at work looking at definitions and trying to develop processes to ensure we have the data needed to participate and compare ourselves to the greater community. In August, we started to see some of our results. Currently, we have data on 3 metrics including central-line associated blood stream infections, catheter-associated urinary tract infections, and unplanned extubations. As a Children’s Hospital, we are performing better than the SPS average in all three categories from January through July of this year.

Metric UVA Children’s Hospital Solutions for Patient Safety

(infections / 1000 line days)

1.004 1.424
    CLABSI – PICU 1.23 1.356
    CLABSI – NICU 0.59 1.01
    CLABSI – Other 1.19 1.025

(infections / 1000 catheter days)

0 1.261
Unplanned Extubations (extubations / 100 ventilator days) 0.31 0.749

These outcomes demonstrate the outstanding work that our Team Members do and the hard work that is required to continue to evaluate opportunities for improvement. Over the last year and a half, the Children’s Hospital has heavily invested in programs to evaluate our processes and outcomes. In addition to SPS, we are now starting to evaluate outcomes through the Pediatric National Surgical Quality Improvement Program, Improve Care Now, and will soon have data from several pediatric cardiology registries. As Fortify starts to take shape, we look forward to looking at our ambulatory primary care outcomes as well.

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