James M Anderson Center for Health Systems Excellence

The All Children Thrive Network is an outgrowth of an innovative partnership between community, social and healthcare organizations. It is our vision that the Learning Network will serve as a catalyst for city-wide collaboration to help Cincinnati’s 66,000 children to be the healthiest in the nation by improving the quality, effectiveness and availability of services provided to all children and families in Cincinnati. The mission is to ensure all children read by third grade, eliminate infant mortality, eliminate disparities impacting children's health across neighborhoods and ensure all 5-year-olds have a "healthy mind and body.”

Learn more about All Children Thrive on Facebook.

The Autism Learning Health Network (ALHN) began in December 2014 and is a growing network of 12 academic medical centers in the US and Canada as part of a membership in the Autism Treatment Network, a longstanding collaboration of Autism Speaks and academic medical institutions specializing in multidisciplinary medical care for children with autism spectrum disorder (ASD). The primary aims, designed by families and clinicians, of ALHN are (1) to improve the health and quality of life for children with ASD and (2) to decrease the number of children with ASD with moderate, severe or extremely severe behaviors focusing on improved identification and treatment of symptoms of Attention Deficit Hyperactivity (ADHD), Anxiety and Irritability. ALHN continues to evolve as a learning health system working with the James M. Anderson Center for Health Systems Excellence and in collaboration with patients, families, clinicians and researchers.

Learn more about the Autism Learning Health Network (ALHN).

The Cystic Fibrosis Foundation is supporting the implementation of the Cystic Fibrosis Learning Network (CFLN), which aims to ensure all people involved with cystic fibrosis (CF) care have access to the information, resources and treatments they need to enable individuals with CF to live full, productive lives. The CFLN launched in October 2016 with twelve pediatric and adult CF care programs, then grew by an additional 14 programs in October 2017. These pilot programs tested and refined improvements in data timeliness, pre-visit planning, and co-production at the program level, leading to the first versions of change packages for each of these areas. The CFLN will bring 16 new programs on board in January 2020. Additionally, the first innovation lab (iLab) focused on the key clinical outcome measure, FEV1-indicated exacerbation signal (FIES), will launch in January 2020 to start early tests of change toward reducing these signals. The CFLN is also focused on developing a health-related quality of life (HRQOL) measure and plans to launch a HRQOL iLab in the spring.

Founded in 2018, ELHS is a growing network of 12 pediatric and adult epilepsy centers across the United States. By connecting epilepsy centers with each other and with community service providers, and co-producing with people with epilepsy and their families, the ELHS will empower all people with epilepsy to live their highest quality of life, striving for freedom from seizures and side effects. We won’t stop until we get there.

Learn more about the Epilepsy Learning Healthcare System.

ImproveCareNow, a network focused on pediatric inflammatory bowel disease (IBD), aims to transform the health, care and costs for all children and adolescents with Crohn’s disease and ulcerative colitis by building a sustainable collaborative chronic care network. ImproveCareNow enables patients, families, clinicians and researchers to work together in a learning healthcare system to accelerate innovation, discovery and the application of new knowledge. ImproveCareNow had six centers in its pilot network in 2007; today, ICN has more than 100 care centers around the globe working together toward a mission to have all children and youth with Crohn’s disease and ulcerative colitis cared for at an ImproveCareNow center, where 82 percent of patients are in clinical remission (feeling well and fully active), 90 percent have satisfactory nutrition, 94 percent have satisfactory growth and 96 percent are not taking steroids. Since 2007, remission rates have risen from 55 percent to 82 percent, without new medications. 

Learn more about ImproveCareNow.

The Improving Renal Outcomes Collaborative (IROC) currently includes 33 kidney transplant clinics in the US that share the vision to partner with patients who have kidney disease and their families to achieve health, longevity and quality of life equivalent to the general population. Member centers share best practices and have successfully implemented research-based methods for accurately measuring blood pressure and for treating renal transplant patients at risk for transplant damage. IROC’s current priority is reducing acute allograft rejection and enhancing the quality of life for kidney transplant patients.

Learn more about the Improving Renal Outcomes Collaborative.

The National Pediatric Cardiology Quality Improvement Collaborative (NPCQIC) includes over 65 pediatric cardiology centers that care for children with complex congenital heart disease and a strong partnership with Sisters-by-Heart, a parent advocacy group.  The registry of infants with hypoplastic left heart disease is the largest in the world with more than 2,100 patients. NPCQIC highlights span improvement, innovation and discovery.  Since July 2013, the mortality rate across centers participating in NPCQIC has decreased by 44 percent; we estimate this is approximately 50 lives saved or the equivalent of two classrooms of kindergartners. NPCQIC has developed a bundle (or set of changes) that has improved growth outcomes in infants prior to their second open-heart surgery.

In 2016, phase II launched, expanding the scope of NPCQIC improvement and research efforts from the “interstage” period (between discharge from the initial open-heart surgery and admission for a bi-directional Glenn procedure) to the interval between diagnosis and celebration of the first birthday for HLHS patients. The aim of phase II is to improve outcomes between diagnosis and first birthday. NPCQIC domain areas are comprised of the following learning structures: Fetal Perinatal, Surgical & ICU, Interstage, Neurodevelopmental, Nutrition and Growth, Patient and Family Support.

At the NPC-QIC Learning Session in fall 2016, one of the plenary sessions highlighted “the paradox  of Fontan circulation”. After that session, interest in expanding NPC-QIC focus to individuals with Fontan circulation began and NPC-QIC/SBH leadership has been instrumental in bringing together a group of clinicians, parents, and patients to begin to design what is called “the Fontan Outcomes Network”. The design work is underway in the three focus areas for the Fontan Outcomes Network –1) Physical Health and Functioning,  2) Neurodevelopment, and 3) Emotional Health and Resiliency (Family CaRes).   Expected to launch in 2020, this network will be organized using the same collaborative principles developed and refined in our last decade of work.

In May 2017, NPC-QIC leadership brought together leaders from a number of other congenital heart networks to begin discussions about collaboration among these groups.  Because of the success NPC-QIC has demonstrated, several other groups have initiated similar registries and networks in our field.  The next version of learning networks in pediatric cardiology, encompassing improvement and research based on a partnership among patients, families, clinicians and researchers needs to be based on cooperation and collaboration among the various emerging collaborations.  The result of these talks has been the development of Cardiac Networks United.  This level of collaboration will transform the way we approach improving outcomes in the field of pediatric and congenital heart disease. Cardiac Networks United held its inaugural meeting in November 2019 and several of the participating learning networks hosted their Learning Sessions during the same week nearby.

Learn more about the National Pediatric Cardiology Quality Improvement Collaborative and Cardiac Networks United.

Through collaborative use of improvement science methods, the Ohio Perinatal Quality Collaborative (OPQC) aims to reduce preterm births and improve perinatal and preterm newborn outcomes in Ohio as quickly as possible.  OPQC worked with clinical teams at 52 Level II and III neonatal units, 105 out of 107 maternity hospitals in the state, 23 outpatient maternity care providers, and nine federally qualified health centers.  Since 2008, OPQC shifted more than 65,000 births to term and reduced bloodstream infections by 31 percent in very premature infants hospitalized in Ohio NICUs. OPQC’s NAS Project increased compassionate care and reduced length of treatment and length of stay for the more than 9,600 infants treated for neonatal abstinence syndrome in Ohio since January 2014. OPQC also decreased the percentage of infants born at less than 32 weeks’ gestation in all Ohio hospitals and decreased the percentage of African-American infants born at less than 32 weeks’ gestation by identifying and treating women at risk of PTB birth with progesterone.  The NICU Graduates Project completed design of a care transition and coordination plan for infants with complex conditions and reduced the time from gastrostomy or tracheostomy tube placement to transition home.

OPQC continues to work with Medicaid managed care plans to identify additional women at risk for preterm birth. Additional OPQC initiatives include the OPQC Smoke Free Families (SFF) project which aims to reduce smoking among pregnant women in order to decrease the effects of smoking on maternal and infant health and the MOMS+ Project which aims to support maternity care providers in the care of pregnant women with Opioid Use Disorder (OUD) to improve care and outcomes for the mother/infant dyad.

Learn more about the Ohio Perinatal Quality Collaborative.

The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) began in 2011 and is a growing network of 18 North American rheumatology care centers focused on improving care and outcomes for children with juvenile idiopathic arthritis, a potentially crippling condition. PR-COIN member centers have improved many care delivery processes and have increased the number of patients with polyarticular arthritis and oligoarthritis experiencing mild or inactive Juvenile Arthritis Disease Activity Scores from 52.1 percent (out of 1220) to 53.9 percent (out of 1904). This represents approximately 391 additional children having either mild or inactive disease scores.

Learn more about the Pediatric Rheumatology − Care and Outcomes Improvement Network.

In 2007, CERTs funded work on identifying adverse drug events using trigger tool methodology at Cincinnati Children’s. This work evolved into a pilot improvement effort involving eight children’s hospitals in Ohio and from there evolved into what is it today, Children’s Hospitals' Solutions for Patient Safety (SPS). The network now consists of 135+ children’s hospitals in North America, caring for 50% of all children hospitalized in the United States. Our mission is to eliminate serious harm across all children’s hospitals by employing high-reliability concepts and quality improvement science methods. We’re focused on reducing harm by preventing serious safety events and hospital-acquired conditions (HACs). SPS efforts have saved an estimated 15,084 children from serious harm and led to an estimated savings of more than $281.1 million in healthcare costs.

Visit the Solutions for Patient Safety website to see our results and yearly safety outcome goals.