March 201919QUALITY AND SAFETY BOARDS: RELUCTANT USER BASEThe notion that we as healthcare providers should anticipate the needs of patients and act on the latest data might seem self-evident. However, as many of us know, it can be difficult to put that philosophy into practice while balancing the needs and perspectives of all those involved in care decisions. The volume and complexity of essential healthcare information can be overwhelming for clinicians balancing the care of multiple patients in need.Children's National Health System has been a leader in pediatric health for years, and one of the drivers of that success across the organization has been a focus on high quality, safe, and proactive pediatric healthcare. As a pediatric critical care specialist and VP, CMIO and CIO, I have had many opportunities to work with organizational leaders, clinical and technical staff members to design approaches to care that allow us to achieve and sustain that balance.One approach that illustrates our success in improving care is through the use of real-time hospital unit-based quality and safety boards visible by clinicians, administrators, patients, and family members throughout all care delivery units in the organization. The boards display important patient safety and quality measures, which can be rapidly acted upon to improve care. For example, in the Pediatric ICU, the boards display each patient's risk for deep vein thrombosis, ventilator-acquired pneumonia, unplanned tracheal extubation, urinary tract infection, and catheter-associated blood stream infections among others. The large-scale, digital monitors refresh every five minutes, allowing physicians, nurses, patients, and family members to directly engage in the assessment of important safety and quality measures and, most importantly, deliver prompt preventative care for every patient.We have noted improvements in care quality in the cardiac ICU through the use of quality and safety boards, including:Lower percentage of patients with urinary catheters in place for more than 96 hours: from 11 percent to 4 percentDecrease in the rate of Catheter Associated UTIs by 31 percent Increase in completion of medication reconciliation to 92 percent from 80 percent at baseline Decrease in the average time from admission to treatment consent by 49 percentThe quality and safety boards have also promoted transparency, accountability, and alignment among our staff members and the patients and family members we serve.TransparencyMany of us have been in the position to manage a healthcare event involving a loved one. I would wager that even those of us who have built our careers working in healthcare organizations have faced difficulties, at Brian JacobsBrian Jacobs, MD, VP, CMIO & CIO, Children's National Health SystemByCIO INSIGHTS
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