Health Policy and Clinical Effectiveness

Serious safety events reduced from 14 to 7, a 50% reduction from FY 2007; business case for quality documented
Inpatient, Emergency Department and PeriOp EMR design sessions begin
CHCA Race for Results Award received for reduction in PICU mortality linked to decline in hospital-acquired infection rates
Picker Institute award for family-centered care
Predictive model for managing flow from Surgery to ICU and for identifying which NICU patients at greatest risk for acquiring VAP
Flow/surge capacity improvement gains measurably demonstrated in Emergency Department, Surgery, and ICUs
Parent-to-parent support groups launched
Chronic Care Self-Management guideline released
Joint Commission Codman Awarded for surgical site infection reduction

Electronic medical record (EMR) development begins; aim is to accelerate clinical outcomes improvement capability for condition-specific populations by hardwiring outcome measures for top three conditions into division EMRs
Enterprise-wide serious safety event reduction initiative launched; aim is to reduce serious safety events by 80% by June 2009
Internally transparent Patient Safety Ticker and blog launched on intranet site
Quality measures posted on external website
Predictive models developed for clinic utilization, inpatient discharge, and OR-to-ICU utilization
Provider dashboards prepared for all medical staff with clinical privileges
PHO asthma initiative receives national recognition as an innovative model linking population health improvement and pay-for-performance
Academic collaboratives launched to embed quality improvement academic divisions

New strategic plan calls for demonstration of best outcomes, experience, and value
Intermediate Improvement Science Series (I2S2) launched to enhance improvement knowledge across team leaders
Annual quality forum launched with attendees from hospital across the U.S.
Annual AHRQ patient safety culture survey launched
Disease Specific Innovations & Outcomes Program (DSIOP) launched
Lean initiatives launched – Laboratory test turnaround times; Pharmacy medication and enteral feeding processes streamlined; Radiology test result cycle times reduced; crash cart contents standardized
AHA-McKesson Quest for Quality Prize award for family-centered care
Joint Commission Codman Award for city-wide improvement collaborative to reduce catheter-associated bloodstream infections

Comparative benchmarking begins in partnership with various external organizations – cardiac surgery outcomes, transplant outcomes, PICU mortality, nosocomial infections, congenital diaphragmatic hernia, ECMO, adverse drug events, etc.
Begin to share stories about changing the outcomes
Methodology for Business Case for Quality analyses is established
Participation in AHRQ/IHI learning collaborative for High Reliability Organizations
Children’s Hospital Improvement Leadership Development (CHILD) workshops established to review progress of improvement teams, provide consultation from experts, and to promote shared learning
Advance Improvement Methods (AIM) course launched
National ratings, rankings, and improvement campaign opportunities are pursued; e.g., 100,000 Lives, US News, CHILD Magazine, Leapfrog
Timely care, access, flow and delays established as strategic improvement priorities
Redesigned measurement of patient experience – more timely, unit-level, actionable data provided

Clinical System Improvement (CSI) teams launched – Inpatient, Outpatient, Emergency, PeriOp, and Home Care – focusing on clinical process improvement
Provider-specific measurement infrastructure is established and individual performance dashboards designed
Vertical alignment of Business Unit dashboards, with key strategic improvement priorities
Physician-Hospital Organization (PHO) reorganized to focus on improvement in community-based asthma care
High reliability principles applied
Formal Patient Safety Program established
Biannual employee satisfaction surveys linked to improvement methods and transparency
Improvement work supported through annual managerial performance appraisal process

Business units adopt IOM dimensions of quality and Dartmouth Clinical Value Compass as models for quality dashboards
Computerized physician order entry (CPOE) is launched as first systemic patient safety initiative
System-level scorecard is developed

Strategic plan calls for transformation of care
Pursuing Perfection grant awarded – developed transformational models for acute and chronic care
Family-centered care model is adopted
Patients and parents invited onto improvement teams
Community health population-focused research infrastructure through the Child Policy Research Center, focused on infant mortality, school-based asthma care, and injury/accident prevention
Development of clinical registries and patient portals begins for specific patient populations

National family-centered care conference attended by senior leadership and board chair
Organization-wide and unit-based Family Advisory Councils established to implement family-centered care

Evidence-based guidelines developed for most common conditions treated in inpatient and emergency department settings
Regionalization of clinical services begins – Newborn/NICU, Psychiatry, Trauma, Oncology, and Transplant