Robert Wood Johnson Foundation Awards Grant
Supports "Pursuing Perfection"
CINCINNATI – Cincinnati Children's Hospital Medical Center is one of seven health-care organizations from across the nation chosen to receive a $1.9 million grant as part of the second stage of a groundbreaking initiative, Pursuing Perfection: Raising the Bar for Health-Care Performance. The $20.9 million initiative is a project of the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI).
Cincinnati Children's is the only pediatric facility among the seven organizations chosen.
"Our goal is to create a health-care delivery system that is timely, efficient, effective, safe, patient-centered, evidence-based and equitable," says James M. Anderson, president and chief executive officer of Cincinnati Children's. "We envision the Pursuing Perfection initiative as the engine that drives the transformational change that is necessary for us to become the leader in improving child health."
More than 200 health-care organizations from across the country applied for Pursuing Perfection grants in the first phase of the program, which began in May 2001. Cincinnati Children's was one of 12 selected to participate in that phase of the initiative.
Participating organizations developed comprehensive plans to systematically improve health-care quality. Cincinnati Children's established two pilot projects for pursuing perfect health-care. These projects focused on children with an acute condition, bronchiolitis, and a chronic condition, cystic fibrosis.
Bronchiolitis
The goal of the bronchiolitis project was to establish a system for acute care delivery that is family-centered and evidence-based. Evidence-based care refers to using research-driven methodology to determine best clinical practice and most cost-effective delivery of care. Families and staff designed and implemented the system. Key results include:
- Parents can now elect to chart their children's progress in medical records that are easily accessible in patient rooms.
- The number of children who did not need to be admitted was significantly reduced and is now below the national average.
- A 71 percent reduction in time taken to discharge patients after they met discharge criteria.
Cystic fibrosis
Patients and parents were full participants in designing and implementing a comprehensive delivery system for children and adolescents. Key results include:
- Adolescents admitted to the hospital helped create a daily schedule customized to meet their own individual needs and desires, such as the time therapy is given.
- A form to solicit parent and patient goals for routine outpatient visits was implemented, resulting in more satisfying and productive visits.
- The proportion of cystic fibrosis patients receiving flu shots increased from 36 percent last year to 86 percent this year. It is important for children and adolescents with cystic fibrosis to receive flu shots to reduce potential respiratory complications from disease.
"I'm particularly excited about this initiative because I've found it to be so honest," says Honor Page, the mother of a 7-year-old girl with cystic fibrosis. Ms. Page's daughter has been coming to Cincinnati Children's for care since she was 3. "I've seen professionals say, 'Maybe there is a better way; let's see what the family thinks.' When you have a chronically ill child, the team is a part of your family. I find it comforting that my input is valuable to them."
Pursuing Perfection was launched last year with the release of a survey showing that more than half of health-care providers and administrators believe the overall quality of health care in the United States is not good. The survey also indicated that 80 percent of medical providers believe fundamental changes are necessary in the health-care system.
"Work being done by Cincinnati Children's is helping to demonstrate that consistently and dependably excellent health care can become a reality," says Risa Lavizzo-Mourey, MD, senior vice president and director of the Health Care Group of RWJF. "We expect the Pursuing Perfection participants to produce compelling examples of how health-care organizations can significantly improve performance."
For the next two years, as one of the seven main-phase grant recipients, Cincinnati Children's has outlined several goals and objectives. Among them are to:
- Extend the comprehensive redesign of inpatient and outpatient care delivery for chronic care to diabetes mellitus and juvenile rheumatoid arthritis.
- Make outpatient clinic appointments available based on the day patients and parents desire.
- Minimize pain for newborns and children with cancer, fractures and lacerations, as well as post-operative pain.
- Dramatically improve efficiency and safety for patients preparing to undergo surgery.
- Extend to acute conditions beyond bronchiolitis the extent to which care is family-centered and based on the best medical science.
The framework for Pursuing Perfection is outlined in the prestigious Institute of Medicine's report, Crossing the Quality Chasm. The report outlines six aims for improving health care: safety, effectiveness, patient-centeredness, timeliness, efficiency and equity.
"The goal of this initiative is to make it possible for patients to be measurably safer, healthier, functioning at higher levels, waiting less time for care and feeling more respected by the health-care system," says Donald M. Berwick, MD, MPP, president and chief executive officer of the Institute for Healthcare Improvement, the national program office for Pursuing Perfection.
The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grant making in four goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse – tobacco, alcohol and illicit drugs.
The Institute for Healthcare Improvement is an integrative force for improving health care worldwide. By harvesting innovative ideas and building bridges for people and organizations committed to real change, IHI leverages the collective energy of health-care organizations to accomplish more together than they can separately. Founded in 1991, the Institute is an independent, non-profit organization based in Boston.
Cincinnati Children's is a 426-bed pediatric medical center, recognized throughout the world for its clinical care, research and education. Scientists at Cincinnati Children's have developed such life-saving research discoveries as the Sabin oral polio vaccine and a surfactant preparation that has saved the lives of many thousands of premature newborns.
In its most recent fiscal year, Cincinnati Children's provided innovative medical and surgical care to patients from 49 states and 12 nations.
Contact Information
Jim Feuer, 513-636-4656,
jfeuer@chmcc.org
