Clinical Indices Can Standardize and Monitor Pediatric Care: A Novel Mechanism to Improve Quality and Safety

被引：6

作者：

Crandall, Wallace ^{[1
,2
]}

Davis, J. Terrance ^{[3
]}

Dotson, Jennifer ^{[2
,4
]}

Elmaraghy, Charles ^{[5
,6
]}

Fetzer, Mike ^{[1
]}

Hayes, Don, Jr. ^{[7
,8
,9
]}

Horwitz, Edwin ^{[8
,10
]}

Kogon, Amy ^{[8
,11
]}

Olshefski, Randal ^{[8
,12
]}

Patel, Hiren ^{[8
,11
]}

Brilli, Richard J. ^{[8
,13
]}

机构：

[1] Nationwide Childrens Hosp, Qual Improvement Serv, Columbus, OH USA

[2] Nationwide Childrens Hosp, Dept Pediat, Div Pediat Gastroenterol Hepatol & Nutr, Columbus, OH USA

[3] Ohio State Univ, Coll Med, Nationwide Childrens Hosp, Hosp Adm, Columbus, OH 43210 USA

[4] Nationwide Childrens Hosp, Res Inst, Columbus, OH USA

[5] Nationwide Childrens Hosp, Dept Pediat Otolaryngol, Columbus, OH USA

[6] Ohio State Univ, Coll Med, Wexner Med Ctr, Dept Otolaryngol Head & Neck Surg, Columbus, OH 43210 USA

[7] Nationwide Childrens Hosp, Div Pulm Med, Columbus, OH USA

[8] Ohio State Univ, Coll Med, Dept Pediat, Columbus, OH 43210 USA

[9] Ohio State Univ, Coll Med, Dept Internal Med, Columbus, OH 43210 USA

[10] Ctr Childhood Canc & Blood Dis, Div Hematol Oncol Bone Marrow Transplantat, Columbus, OH USA

[11] Nationwide Childrens Hosp, Div Pediat Nephrol, Columbus, OH USA

[12] Nationwide Childrens Hosp, Div Hematol Oncol Bone Marrow Transplant, Columbus, OH USA

[13] Nationwide Childrens Hosp, Dept Pediat, Div Pediat Crit Care Med, Columbus, OH USA

来源：

JOURNAL OF PEDIATRICS | 2018年 / 193卷

关键词：

PREVENTABLE HARM; BLOOD-PRESSURE; CHILDREN; DISEASE; CANCER; ADULTS; AGE;

D O I：

10.1016/j.jpeds.2017.09.073

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Objective The Cancer Care Index (CCI), a single metric that sums the number of undesirable patient events in a given time frame (either preventable harm events or missed opportunities to provide optimal care), resulted in a 42% improvement in performance. Our objective was to test the index concept in other service lines to determine whether similar performance improvement occurred. Study design Care indices were developed and introduced in 3 additional service lines: Nephrology (Chronic Kidney Disease Care Index; CKDCI), Pulmonology (Lung Transplantation Care Index; LTCI), and Otolaryngology (Tracheostomy Care Index; TCI). After reaching agreement on specific harms to be avoided and elements of optimal care that should be reliably delivered, these items were compiled into indices that were updated monthly. Reports included each element individually and the total for all elements. Baseline performance was calculated retrospectively for the previous year. Results Significant improvement in performance occurred in each program following implementation of the clinical indices. The CKDCI was decreased by 63.2% (P < .001), the LTCI was decreased by 89.5% (P < .001), and the TCI was decreased by 53.0% (P < .001). Surveyed staff indicated satisfaction with use of the metric. Conclusions Clinical indices are useful for evaluating and managing the overall reliability of a program's ability to deliver optimal care, and are associated with improved clinical performance and satisfaction by service line staff when incorporated into a program's operation.

引用

页码：190 / +

页数：7

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