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Erschienen in:

01.06.2019 | Patient Safety (M Scanlon, Section Editor)

Accelerating Improvement in Children’s Healthcare Through Quality Improvement Collaboratives: a Synthesis of Recent Efforts

verfasst von: Michael Terao, MD, FAAP, James M. Hoffman, PharmD, MS, Richard J. Brilli, MD, FAAP, MCCM, Amanda Finch, BS, PMP,, Kathleen E. Walsh, MD, MS, Maitreya Coffey, MD, FAAP, FRCP(C)

Erschienen in: Current Treatment Options in Pediatrics | Ausgabe 2/2019

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Abstract

Purpose of review

Quality improvement collaboratives can accelerate quality improvement and patient safety efforts. We reviewed major pediatric quality improvement collaboratives that have published results in the past 5 years and discussed common success factors and barriers encountered by these collaboratives.

Recent findings

Many pediatric quality improvement collaboratives are active in neonatal, cystic fibrosis, congenital heart disease, hematology/oncology, chronic kidney disease, rheumatology, critical care, and general pediatric care.

Summary

Factors important to the success of these pediatric quality improvement collaboratives include data sharing and communication, trust among institutions, financial support, support from national organizations, use of a theoretical framework to guide collaboration, patient and family involvement, and incentives for participation at both the individual and institutional levels. Common barriers encountered by these collaboratives include insufficient funding or resources, legal concerns, difficulty coming to consensus on best practices and outcome measures, and overcoming cultural barriers to change. Learning from the successes and challenges encountered by these collaboratives will enable the pediatric healthcare quality improvement community to continue to evolve this approach to maximize benefits to children.

Institute of Medicine, Committee on Quality of Health Care in America. To Err Is Human: Building a Safer Health System [Internet], National Academies Press; 2000. Available from: https://www.ncbi.nlm.nih.gov/books/NBK225182/

Institute of Medicine: Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century [Internet]. In: Briere R, editor. Washington, DC: National Academies Press; 2001. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222274/pdf/Bookshelf_NBK222274.pdf

Stockwell DC, Landrigan CP, Toomey SL, Loren SS, Jang J, Quinn JA, et al. for the GAPPS Study Group Adverse events in hospitalized pediatric patients. Pediatrics [Internet]. Am Acad Pediatr. 2018;142. https://doi.org/10.1542/peds.2017-3360.

Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA [internet]. 1999;282:1458–65. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10535437.CrossRefPubMed

•• Wells S, Tamir O, Gray J, Naidoo D, Bekhit M, Goldmann D. Are quality improvement collaboratives effective? A systematic review. BMJ Qual Saf [Internet]. 2018;27:226–40. https://doi.org/10.1136/bmjqs-2017-006926. This is a systematic review and meta-analysis of the effectiveness of quality improvement collaboratives. This article also provides a comprehensive and clear definition of a quality improvement collaborative.

Waters HR, Korn R Jr, Colantuoni E, Berenholtz SM, Goeschel CA, Needham DM, et al. The business case for quality: economic analysis of the Michigan Keystone Patient Safety Program in ICUs. Am J Med Qual [Internet]. 2011;26:333–9. https://doi.org/10.1177/1062860611410685.

Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med [Internet]. 2006;355:2725–32. https://doi.org/10.1056/NEJMoa061115.CrossRefPubMed

Bennett SC, Finer N, Halamek LP, Mickas N, Bennett MV, Nisbet CC, et al. Implementing delivery room checklists and communication standards in a multi-neonatal ICU quality improvement collaborative. Jt Comm J Qual patient Saf [internet]. 2016;42:369–76. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27456419.CrossRefPubMed

California Perinatal Quality. Who We Are [Internet]. California Perinatal Quality Care Collaborative. [cited 2018 Oct 9]. Available from: https://www.cpqcc.org/about/who-we-are

10.

•• Lee HC, Bennett MV, Crockett M, Crowe R, Gwiazdowski SG, Keller H, et al. Comparison of collaborative versus single-site quality improvement to reduce NICU length of stay. Pediatr Int. 2018;142:e20171395. https://doi.org/10.1542/peds.2017-1395. This study from the California Perinatal Quality of Care Collaborative demonstrates greater improvement in quality improvement collaboratives compared to individual institutions working in isolation. However, it is important to keep in mind that there could have been significant selection bias regarding which institutions joined the collaborative effort making this data less reliable.

11.

Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta-Fobes T, Hanson-Timpson TA, et al. A quality improvement project to increase breast milk use in very low birth weight infants. Pediatr Int. 2012;130:e1679–87. https://doi.org/10.1542/peds.2012-0547.

12.

Lapcharoensap W, Bennett MV, Powers RJ, Finer NN, Halamek LP, Gould JB, et al. Effects of delivery room quality improvement on premature infant outcomes. J Perinatol [Internet]. 2017;37:349–54. https://doi.org/10.1038/jp.2016.237.

13.

Lee HC, Powers RJ, Bennett MV, Finer NN, Halamek LP, Nisbet C, et al. Implementation methods for delivery room management: a quality improvement comparison study. Pediatr Int. 2014;134:e1378–86. https://doi.org/10.1542/peds.2014-0863.

14.

• Walsh MC, Crowley M, Wexelblatt S, Ford S, Kuhnell P, Kaplan HC, et al. Ohio Perinatal Quality Collaborative improves care of neonatal narcotic abstinence syndrome. Pediatrics [internet]. 2018;141. https://doi.org/10.1542/peds.2017-0900. This article describes a successful collaborative effort by the CPQCC to decrease total treatment time and length of stay for neonatal abstinence syndrome.

15.

California Perinatal Quality Care Collaborative | [Internet]. [cited 2018 Nov 5]. Available from: https://www.cpqcc.org/

16.

Mogayzel PJ Jr, Dunitz J, Marrow LC, Hazle LA. Improving chronic care delivery and outcomes: the impact of the cystic fibrosis Care Center Network. BMJ Qual Saf [Internet]. 2014;23(Suppl 1):i3–8. https://doi.org/10.1136/bmjqs-2013-002363.CrossRefPubMed

17.

Godfrey MM, Oliver BJ. Accelerating the rate of improvement in cystic fibrosis care: contributions and insights of the learning and leadership collaborative. BMJ Qual Saf [Internet]. 2014;23(Suppl 1):i23–32. https://doi.org/10.1136/bmjqs-2014-002804.CrossRefPubMed

18.

Marshall BC, Nelson EC. Accelerating implementation of biomedical research advances: critical elements of a successful 10 year Cystic Fibrosis Foundation healthcare delivery improvement initiative. BMJ Qual Saf [Internet]. 2014;23(Suppl 1):i95–103. https://doi.org/10.1136/bmjqs-2013-002790.CrossRefPubMed

19.

Godfrey M. Email from Majorie Godfrey to Michael Terao. 2018.

20.

Kugler JD, Iii BRH, Rosenthal GL, Jenkins KJ, Klitzner TS, Martin GR, et al. Development of a pediatric cardiology quality improvement collaborative: from inception to implementation. From the Joint Council on Congenital Heart Disease Quality Improvement Task Force. Congenit Heart Dis [Internet]. 2009;4:318–28. https://doi.org/10.1111/j.1747-0803.2009.00328.x.CrossRefPubMed

21.

•• Anderson JB, Beekman RH 3rd, Kugler JD, Rosenthal GL, Jenkins KJ, Klitzner TS, et al. Improvement in interstage survival in a national pediatric cardiology learning network. Circ Cardiovasc Qual Outcomes [Internet]. 2015;8:428–36. https://doi.org/10.1161/CIRCOUTCOMES.115.001956. This paper summarizes the efforts and success of the National Pediatric Cardiology Quality Improvement Collaborative to improve survival in infants with hypoplastic left heart. It describes many of the challenges faced by this collaborative and the ways these challenges were overcome.

22.

•• Lihn SL, Kugler JD, Peterson LE. Transparency in a pediatric quality improvement collaborative: a passionate journey by NPC-QIC clinicians and parents. Congenit Heart Dis [Internet]. Wiley Online Library; 2015;10:572–80. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/chd.12314. This paper describes the barriers faced by the National Pediatric Cardiology Quality Improvement Collaborative as it attempted to make data sharing more transparent among member institutions and the public.

23.

Anderson JB, Beekman RH III, Kugler JD. Use of a learning network to improve variation in interstage weight gain after the Norwood operation. Congenit Heart Dis [internet]. Wiley Online Library; 2014;9:512–20. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/chd.12232

24.

Anderson JB, Brown D, Lihn S, Tweddell J, Hansen J, McDonald M, et al. Revenue return on investment for center involvement in a quality improvement collaborative for a rare disease: national pediatric cardiology quality improvement collaborative. J Am Coll Cardiol [Internet]. 2017;69:612 Available from:http://www.onlinejacc.org/content/69/11_Supplement/612.CrossRef

25.

• Hill GD, Rudd NA, Ghanayem NS, Hehir DA, Bartz PJ. Center variability in timing of stage 2 palliation and association with interstage mortality: a report from the National Pediatric Cardiology Quality Improvement Collaborative. Pediatr Cardiol [Internet]. 2016;37:1516–24. https://doi.org/10.1007/s00246-016-1465-9. This is a report from the National Pediatric Cardiology Quality Improvement Collaborative that demonstrates how a QIC can be used for research purposes in addition to quality improvement purposes.

26.

National Pediatric Cardiology Quality Improvement Collaborative [Internet]. [cited 2018 Nov 5]. Available from: https://npcqic.org/

27.

Crandall W, Kappelman MD, Colletti RB, Leibowitz I, Grunow JE, Ali S, et al. ImproveCareNow: the development of a pediatric inflammatory bowel disease improvement network. Inflamm Bowel Dis [Internet]. 2011;17:450–7. https://doi.org/10.1002/ibd.21394.CrossRefPubMed

28.

ImproveCareNow. Care centers [Internet]. ImproveCareNow. [cited 2018 Oct 9]. Available from: https://www.improvecarenow.org/care-centers

29.

•• Seid M, Dellal G, Peterson LE, Provost L, Gloor PA, Fore DL, et al. Co-designing a Collaborative Chronic Care Network (C3N) for inflammatory bowel disease: development of methods. JMIR Hum Factors [Internet]. 2018;5:e8. https://doi.org/10.2196/humanfactors.8083. This article describes the intricate process used to design the ImproveCareNow Network, including using ideas from social movements to increase collaboration and buy in.

30.

Crandall WV, Margolis PA, Kappelman MD, King EC, Pratt JM, Boyle BM, et al. Improved outcomes in a quality improvement collaborative for pediatric inflammatory bowel disease. Pediatr Int. 2012;129:e1030–41. https://doi.org/10.1542/peds.2011-1700.

31.

• Marsolo K, Margolis PA, Forrest CB, Colletti RB, Hutton JJ. A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research. EGEMS (wash DC) [internet]. 2015;3:1168. https://doi.org/10.13063/2327-9214.1168. This article describes how collaboration with electronic medical record vendors helped ImproveCareNow design software that significantly reduced the data entry burden faced by clinicians.

32.

ImproveCareNow. ImproveCareNow [Internet]. ImproveCareNow. [cited 2018 Nov 5]. Available from: https://www.improvecarenow.org/

33.

Ralston S, Garber M, Narang S, Shen M, Pate B, Pope J, et al. Decreasing unnecessary utilization in acute bronchiolitis care: results from the value in inpatient pediatrics network. J Hosp Med [Internet]. 2013;8:25–30. https://doi.org/10.1002/jhm.1982.CrossRefPubMed

34.

Ralston SL, Garber MD, Rice-Conboy E, Mussman GM, Shadman KA, Walley SC, et al. A multicenter collaborative to reduce unnecessary care in inpatient bronchiolitis. Pediatr Int. 2016;137:eds. 2015–0851. https://doi.org/10.1542/peds.2015-0851.

35.

Parikh K, Biondi E, Nazif J, Wasif F, Williams DJ, Nichols E, et al. A multicenter collaborative to improve care of community acquired pneumonia in hospitalized children. Pediatr Int. 2017;139:e20161411. https://doi.org/10.1542/peds.2016-1411.

36.

Ralston S. Email from Shawn Ralston to Maitreya Coffey. 2018.

37.

Lyren A, Brilli R, Bird M, Lashutka N, Muething S. Ohio children’s hospitals’ solutions for patient safety: a framework for pediatric patient safety improvement. J Healthc Qual [Internet]. 2013;38(4):213–22. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jhq.12058.CrossRef

38.

•• Lyren A, Brilli RJ, Zieker K, Marino M, Muething S, Sharek PJ. Children’s hospitals’ solutions for patient safety collaborative impact on hospital-acquired harm. Pediatr Int. 2017;140:e20163494 Available from: http://pediatrics.aappublications.org/content/140/3/e20163494. This paper highlights the success of the Children’s Hospitals’ Solutions for Patient Safety Network in reducing hospital-acquired harm in multiple areas. This article is a strong example of the power of the “all teach, all learn” philosophy to drive rapid improvement.

39.

Toltzis P, O’Riordan M, Cunningham DJ, Ryckman FC, Bracke TM, Olivea J, et al. A statewide collaborative to reduce pediatric surgical site infections. Pediatr Int. 2014;134:e1174–80. https://doi.org/10.1542/peds.2014-0097.

40.

• Frank G, Walsh KE, Wooton S, Bost J, Dong W, Keller L, et al. Impact of a pressure injury prevention bundle in the solutions for patient safety network. Pediatr Qual Saf [Internet]. 2017;2:e013. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132915/. This paper describes the success of the Children’s Hospitals’ Solutions for Patient Safety Network in reducing pressure injuries through implementation of a pressure injury prevention bundle. This network functioned through the “all teach, all learn” philosophy with the sharing of keys to success and common barriers encountered during this implementation to accelerate improvement.

41.

• Schaffzin JK, Harte L, Marquette S, Zieker K, Wooton S, Walsh K, et al. Surgical site infection reduction by the solutions for patient safety hospital engagement network. Pediatr Int. 2015;136:e1353–60. https://doi.org/10.1542/peds.2015-0580. This article highlights the success of the Children’s Hospitals’ Solutions for Patient Safety Network in reducing surgical site infections through a quality improvement collaborative. This network used the “all teach, all learn” philosophy to share keys to success and common barriers in the implementation of the prevention bundle.

42.

•• Lyren A, Coffey M, Shepherd M, Lashutka N, Muething S, SPS Leadership Group. We will not compete on safety: how children’s hospitals have come together to hasten harm reduction. Jt Comm J Qual patient Saf [internet]. Elsevier; 2018;44:377–88. https://doi.org/10.1016/j.jcjq.2018.04.005. This article is a summary of the successful efforts of the Children’s Hospitals’ Solutions for Patient Safety Network to decrease preventable harm to children and employees/staff.

43.

Children’s Hospitals’ Solutions for Patient Safety [Internet]. [cited 2018 Nov 5]. Available from: https://www.solutionsforpatientsafety.org/

44.

Gaur AH, Bundy DG, Werner EJ, Hord JD, Miller MR, Tang L, et al. A prospective, holistic, multicenter approach to tracking and understanding bloodstream infections in pediatric hematology-oncology patients. Infect Control Hosp Epidemiol [Internet]. 2017;38:690–6. https://doi.org/10.1017/ice.2017.57.

45.

Bundy DG, Gaur AH, Billett AL, He B, Colantuoni EA, Miller MR, et al. Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results. Pediatr Int. 2014;134:e1678–85. https://doi.org/10.1542/peds.2014-0582.

46.

Esporas M. Email from Megan Esporas to Michael Terao. 2018.

47.

National Institute for Children’s Health Quality. Sickle Cell Disease Treatment Demonstration Program: Congressional Report [Internet]. 2014. Available from: http://med.stanford.edu/content/dam/sm/cpop/documents/Wang-NICHQ_SCDTDP-Congressional-Report-Oct-2014.pdf. Accessed 7 Nov 2018.

48.

Sickle Cell Disease Treatment Demonstration Regional Collaborative Program National Coordinating Center [Internet]. NICHQ - National Institute for Children’s Health Quality. [cited 2018 Nov 7]. Available from: https://www.nichq.org/project/sickle-cell-disease-treatment-demonstration-regional-collaborative-program-national.

49.

Bigham MT, Logsdon TR, Manicone PE, Landrigan CP, Hayes LW, Randall KH, Grover P, Collins SB, Ramirez DE, O'Guin CD, Williams CI, Warnick RJ, Sharek PJ Decreasing handoff-related care failures in children’s hospitals. Pediatrics [internet]. Am Acad Pediatrics; 2014;134:e572–9. Available from: doi:https://doi.org/10.1542/peds.2013-1844

50.

Neu AM, Miller MR, Stuart J, Lawlor J, Richardson T, Martz K, et al. Design of the standardizing care to improve outcomes in pediatric end stage renal disease collaborative. Pediatr Nephrol [Internet]. 2014;29:1477–84. https://doi.org/10.1007/s00467-014-2891-7.CrossRefPubMed

51.

Neu AM, Richardson T, Lawlor J, Stuart J, Newland J, McAfee N, et al. Implementation of standardized follow-up care significantly reduces peritonitis in children on chronic peritoneal dialysis. Kidney Int [Internet]. Elsevier; 2016 [cited 2018 26];89:1346–54. Available from: doi:https://doi.org/10.1016/j.kint.2016.02.015

52.

Children’s Hospital Association. SCOPE Dialysis Collaborative [Internet]. Children’s Hospital Association. [cited 2018 Oct 10]. Available from: https://www.childrenshospitals.org/Programs-and-Services/Quality-Improvement-and-Measurement/Collaboratives/SCOPE

53.

Sethna CB, Bryant K, Munshi R, Warady BA, Richardson T, Lawlor J, et al. Risk factors for and outcomes of catheter-associated peritonitis in children: the SCOPE collaborative. Clin J Am Soc Nephrol [Internet]. 2016;11:1590–6. https://doi.org/10.2215/CJN.02540316.CrossRefPubMedPubMedCentral

54.

PR-COIN. Teams [Internet]. PR-COIN. [cited 2018 Oct 10]. Available from: https://pr-coin.org/pr-coin-teams

55.

• Harris JG, Bingham CA, Morgan EM. Improving care delivery and outcomes in pediatric rheumatic diseases. Curr Opin Rheumatol [internet]. 2016;28:110–6. https://doi.org/10.1097/BOR.0000000000000257. The authors summarize the structure and successes of the Pediatric Rheumatology Care and Outcomes Improvement Network.

56.

PR-COIN. About [Internet]. PR-COIN. [cited 2018 Oct 10]. Available from: https://pr-coin.org/about

57.

DeWitt EM, Ardoin SP, Bingham C, Gottlieb BS, Laxer RM, Griffin N, et al. Increasing rates of remission in juvenile idiopathic arthritis through a quality improvement learning network-the Pediatric Rheumatology Care and Outcomes Improvement Network [internet]. 2014. Available from: https://acrabstracts.org/abstract/increasing-rates-of-remission-in-juvenile-idiopathic-arthritis-through-a-quality-improvement-learning-network-the-pediatric-rheumatology-care-and-outcomes-improvement-network/

58.

DeWitt EM, Fricke K, Bergheger L, Griffin N, Laxer RM, Jones KB, et al. A147: engaging patients and families in the pediatric rheumatology care and outcomes improvement network. Arthritis Rheum [Internet]. 2014;66:S190–0. http://doi.wiley.com/10.1002/art.38568.

59.

Harris JG, DeWitt EM, Laxer RM, Ardoin SP, Gottlieb BS, Olson JC, et al. A151: pediatric rheumatology care and outcomes improvement network demonstrates performance improvement on juvenile idiopathic arthritis quality measures. Arthritis Rheum [Internet]. 2014;66:S195–5. http://doi.wiley.com/10.1002/art.38577.

60.

Oliver MS, Weiss JE, Li SC, Haines KA, Janow GL, Dewitt EM, et al. Enhancing uveitis screening compliance in juvenile idiopathic arthritis patients: 2789. Arthritis Rheum [Internet] Arthritis & Rheumatism. 2013;65:S1193–4. Available from: https://insights.ovid.com/arthritis-rheumatism/arhe/2013/10/001/enhancing-uveitis-screening-compliance-juvenile/2789/00000889.

61.

Children’s Hospital Association. Improving pediatric sepsis outcomes: a multi-year collaborative for children’s hospitals to reduce sepsis mortality and morbidity across all levels of care [Internet]. Available from: https://www.childrenshospitals.org/-/media/Files/CHA/Main/Programs_and_Services/Quality_Safety_and_Performance/Collaboratives/Sepsis/Prospectus_CHA_Sepsis_Collaborative.la=en&hash=D27A7AE9893E1373B3194E507CAC0CEA5811CA28. Accessed 22 Oct 2018.

62.

Children’s Hospital Association. Improving pediatric sepsis outcomes - March 2015 newsletter [Internet]. Children’s Hospital Association. 2015 [cited 2018 Oct 26]. Available from: https://www.childrenshospitals.org/newsroom/newsletters/improving-pediatric-sepsis-outcomes/2015/improving-pediatric-sepsis-outcomes-march-2015

63.

Bright STAR Collaborative | Johns Hopkins Children’s Center [Internet]. Johns Hopkins Children’s Center. [cited 2018 Oct 22]. Available from: https://www.hopkinsmedicine.org/johns-hopkins-childrens-center/what-we-treat/specialties/infectious-diseases/programs-centers/bright-star/index.html

64.

Kilo CM. A framework for collaborative improvement: lessons from the Institute for Healthcare Improvement’s Breakthrough Series. Qual Manag Health Care [Internet]. 1998;6:1–13. Available from: http://www.centertrt.org/content/docs/Intervention_Documents/Intervention_Materials/OSNAP/Framework_for_Collaborative.CrossRefPubMed

65.

Britto MT, Fuller SC, Kaplan HC, Kotagal U, Lannon C, Margolis PA, et al. Using a network organisational architecture to support the development of Learning Healthcare Systems. BMJ Qual Saf [Internet]. 2018;27:937–46. https://doi.org/10.1136/bmjqs-2017-007219.CrossRefPubMedPubMedCentral

66.

Nelson EC, Batalden PB, Huber TP, Mohr JJ, Godfrey MM, Headrick LA, et al. Microsystems in health care: part 1. Learning from high-performing front-line clinical units. Jt Comm J Qual Improv [internet]. Elsevier; 2002;28:472–93. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12216343.

67.

Nelson EC, Batalden PB, Godfrey MM. Quality by design: a clinical microsystems approach: John Wiley & Sons; 2011.

68.

Forrest CB, Margolis P, Seid M, Colletti RB. PEDSnet: how a prototype pediatric learning health system is being expanded into a national network. Health Aff [Internet]. 2014;33:1171–7. https://doi.org/10.1377/hlthaff.2014.0127.

69.

Quality Improvement [Internet]. New York State Department of Health AIDS Institute. [cited 2018 Nov 7]. Available from: https://www.hivguidelines.org/quality-of-care/about-the-program/quality-improvement/

70.

New York State Department of Health AIDS Institute Health Resources and Services Administration HIV/AIDS Bureau. HIVQUAL Workbook [Internet]. New York State Department of Health AIDS Institute Health Resources and Services Administration HIV/AIDS Bureau ; 2006. Available from: http://nationalqualitycenter.org/files/hivqual-workbook/

71.

Weiser J, Beer L, Frazier EL, Patel R, Dempsey A, Hauck H, et al. Service delivery and patient outcomes in Ryan White HIV/AIDS Program--funded and--nonfunded health care facilities in the United States. JAMA Intern Med [internet]. American Medical Association; 2015;175:1650–9. Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2430794

72.

Brighton BK. National Surgical Quality Improvement Program-Pediatric (NSQIP) and the quality of surgical care in pediatric orthopaedics. J Pediatr Orthop [Internet]. 2015;35:S48–50. https://doi.org/10.1097/BPO.0000000000000548.

73.

Bruny JL, Hall BL, Barnhart DC, Billmire DF, Dias MS, Dillon PW, et al. American College of Surgeons National Surgical Quality Improvement Program Pediatric: a beta phase report. J Pediatr Surg [Internet]. 2013;48:74–80. https://doi.org/10.1016/j.jpedsurg.2012.10.019.CrossRefPubMed

74.

• Serres SK, Cameron DB, Glass CC, Graham DA, Zurakowski D, Karki M, et al. Time to appendectomy and risk of complicated appendicitis and adverse outcomes in children. JAMA Pediatr [Internet]. 2017;171:740–6. https://doi.org/10.1001/jamapediatrics.2017.0885jamanetwork.com. This article summarizes outcome data regarding appendicitis from the NSQIP-Pediatric, which does not meet the definition of a quality improvement collaborative outlined in this article but is a large pediatric data-gathering group.

75.

• Basques BA, Lukasiewicz AM, Samuel AM, Webb ML, Bohl DD, Smith BG, et al. Which pediatric orthopaedic procedures have the greatest risk of adverse outcomes? J Pediatr Orthop [Internet]. 2017;37:429–34. https://doi.org/10.1097/BPO.0000000000000683ingentaconnect.com. This is a report from the National Surgical Quality Improvement Program-Pediatric that looks at adverse outcomes for pediatric orthopedic procedures. While the National Surgical Quality Improvement Program-Pediatric does not meet the definition of a quality improvement collaborative outlined in this article it is visible in aggregating data for definition of a quality improvement collaborative outlined in this article it is visible in aggregating data for pediatrics surgery.

76.

Gaies M, Cooper DS, Tabbutt S, Schwartz SM, Ghanayem N, Chanani NK, et al. Collaborative quality improvement in the cardiac intensive care unit: development of the Paediatric Cardiac Critical Care Consortium (PC4). Cardiol Young [Internet]. 2015;25:951–7. https://doi.org/10.1017/S1047951114001450.CrossRefPubMed

77.

Alten JA, Klugman D, Raymond TT, Cooper DS, Donohue JE, Zhang W, et al. Epidemiology and outcomes of cardiac arrest in pediatric cardiac ICUs. Pediatr Crit Care Med [Internet]. 2017;18:935–43. https://doi.org/10.1097/PCC.0000000000001273.CrossRefPubMedPubMedCentral

78.

Gaies MG, Jeffries HE, Niebler RA, Pasquali SK, Donohue JE, Yu S, et al. Vasoactive-Inotropic Score (VIS) is associated with outcome after infant cardiac surgery: an analysis from the Pediatric Cardiac Critical Care Consortium (PC4) and virtual PICU system registries. Pediatr Crit Care Med [Internet]. 2014;15:–529. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159673.

79.

Warren BB, Ranade D, Wathen B, Valdez S, Pickard D, Goldenberg NA, et al. Daily evaluation of venous thromboembolism (vte) risk factors and prophylaxis safely decreased incidence of VTE in a pediatric ICU. Blood [Internet]. American Society of Hematology; 2014 [cited 2018 26];124:4860–4860. Available from: http://www.bloodjournal.org/content/124/21/4860.abstract

80.

Iams J, Ford S, White B, Bouchard J, Friar K, Kassouf M, et al. 766: Dissemination of an obstetrical quality improvement (QI) initiative using birth certificates. Am J Obstet Gynecol [internet]. Elsevier; 2013;208:S321–2. Available from: doi:https://doi.org/10.1016/j.ajog.2012.10.104.

81.

Shein D, Bowen J, Callander I, Richards R, Bowers S, Lindrea KB, et al. A state-wide collaborative quality improvement programme: decreasing central line associated blood stream infections. J Paediatr Child Health [Internet]. 2013;49:103. Available from: https://insights.ovid.com/paediatrics-child-health/jpechh/2013/04/000/state-wide-collaborative-quality-improvement/327/00002208.CrossRef

82.

• Meropol SB, Schiltz NK, Sattar A, Stange KC, Nevar AH, Davey C, et al. Practice-tailored facilitation to improve pediatric preventive care delivery: a randomized trial. Pediatr Int. 2014;133:e1664–75. https://doi.org/10.1542/peds.2013-1578. This study looked at the effectiveness of a practice facilitator visiting various primary care clinics to improve preventive care. The use of a practice facilitator to help clinics with their preventative care delivery resulted in significant improvement in preventive care delivery. This article describes a method to improve primary care services in a somewhat collaborative setting.

83.

• Engels MJ, Ciarkowski SL, Rood J, Wang B, Wagenknecht LD, Dickinson CJ, et al. Standardization of compounded oral liquids for pediatric patients in Michigan. Am J Health Syst Pharm [Internet]. 2016;73:981–90. https://doi.org/10.2146/150471. This study involved multiple pharmacies in Michigan with a statewide effort to standardize medication concentrations to decrease errors. While this statewide effort does not meet the definition of a QIC outlined in this article, this was one of the few efforts to focus explicitly on the quality of the medication use process.

84.

Starmer AJ, Spector ND, Srivastava R, West DC, Rosenbluth G, Allen AD, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med [Internet]. 2014;371:1803–12. https://doi.org/10.1056/NEJMsa1405556.CrossRefPubMed

85.

Nishisaki A, Lee A, Li S, Sanders R, Brown C, Napolitano N, et al. 1072: Multicenter qi collaborative to improve safety of pediatric icu tracheal intubations. Crit Care Med [Internet]. 2016;44:344. https://doi.org/10.1097/01.ccm.0000509748.23142.24.CrossRef

86.

Billett AL, Colletti RB, Mandel KE, Miller M, Muething SE, Sharek PJ, et al. Exemplar pediatric collaborative improvement networks: achieving results. Pediatr Int. 2013;131(Suppl 4):S196–203. https://doi.org/10.1542/peds.2012-3786F.

87.

Clancy CM, Margolis PA, Miller M. Collaborative networks for both improvement and research. Pediatr Int. 2013;131(Suppl 4):S210–4. https://doi.org/10.1542/peds.2012-3786H.

Titel: Accelerating Improvement in Children’s Healthcare Through Quality Improvement Collaboratives: a Synthesis of Recent Efforts
verfasst von: Michael Terao, MD, FAAP
James M. Hoffman, PharmD, MS
Richard J. Brilli, MD, FAAP, MCCM
Amanda Finch, BS, PMP,
Kathleen E. Walsh, MD, MS
Maitreya Coffey, MD, FAAP, FRCP(C)
Publikationsdatum: 01.06.2019
Verlag: Springer International Publishing
Erschienen in: Current Treatment Options in Pediatrics / Ausgabe 2/2019
Elektronische ISSN: 2198-6088
DOI: https://doi.org/10.1007/s40746-019-00155-6

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Springer Medizin

Accelerating Improvement in Children’s Healthcare Through Quality Improvement Collaboratives: a Synthesis of Recent Efforts

Abstract

Purpose of review

Recent findings

Summary

Weitere Artikel der Ausgabe 2/2019

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Recent findings

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