Active Learning Networks

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Thrive logo.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 across neighborhoods in the health of children and ensure all 5-year-olds have a "healthy mind and body.”

Learn more about All Children Thrive on Facebook.

AIR logoThe Autism Learning Network was initiated in December 2014. Twelve academic medical centers in the US and Canada are active participants in the learning network as part of membership in the Autism Treatment Network, a decade-old collaboration of Autism Speaks and academic medical institutions specializing in multidisciplinary medical care for children with autism. The primary aims, designed by families and clinicians, of the Autism Learning Network are (1) to improve the health and quality of life for children with autism spectrum disorder (ASD) and (2) to increase the number of children with ASD who receive routine health services. Currently in the implementation phase, the learning network continues to evolve toward 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 Network.

Children’s Hospitals’ Solutions for Patient Safety (SPS) Network.In 2007, CERTs funded work on identifying adverse drug events using trigger tool methodology at Cincinnati Children’s Hospital Medical Center.  That evolved into a pilot improvement effort involving eight children’s hospitals in Ohio. This effort received funding from the Cardinal Health Foundation and then from CMS to expand into a national safety network. The SPS Network is funded in part by the Cardinal Health Foundation, the Children’s Hospital Association and the federal Partnership for Patients initiative. Today the Children’s Hospitals’ Solutions for Patient Safety (SPS) Network is a 110+ site network of children’s hospitals in North America, caring for 50 percent of all children hospitalized in the United States, whose purpose is to eliminate serious harm across all children’s hospitals.  Between 2012 and September 2016, SPS efforts have saved 6,944 children from serious harm and led to an estimated savings of more than $130 million in healthcare costs. The SPS Network has had tremendous success in reducing harm through January 2017:

  • Falls: 81%
  • ADE: 64%
  • CAUTI: 62%
  • SSI: 31%
  • PI: 26%
  • CLABSI: 13% (2012-2014)
  • Readmissions 7%
  • VTE Events: 5%  

Learn more about improved safety outcomes at Solutions for Patient Safety.

CF Foundation.The CF Foundation is supporting the development of the CF Care Model of the Future, a Learning Network that aims to ensure all people involved with CF care have access to the information, resources and treatments they need to enable individuals with CF to live full, productive lives. The design of this model was created throughout 2015 in partnership with a group of about 80 experts in CF care, including clinicians, people with CF and family caregivers, as well as researchers, scientists, foundation leadership, and other collaborators. Beginning in August 2016, 13 CF clinics enrolled in the pilot CF Learning Network to test, refine and implement the recommended changes by engaging in continuous, collaborative quality improvement together. A family of measures is being tested and refined following the inaugural Community Conference in October 2016, where teams identified 90- and 180-day goals and committed to monthly data collection to monitor progress toward improvement.

As part of statewide infant mortality reduction efforts, the Ohio Department of Health’s Home Visiting programs (including HMG, MIECHV and OIMRI providers) seek to optimize prenatal referrals to home visiting and enhance care connections among home visiting agencies, Medicaid managed care plans, and maternity care providers. This effort will leverage prior efforts to develop a statewide home visiting learning network in collaboration with the Cincinnati Children’s Hospital Medical Center’s James M. Anderson Center for Health Systems Excellence.  The Home Visiting Collaborative Learning Network (HVCLN) will pilot test interventions to increase early prenatal engagement among at-risk mothers in 10 home visiting agencies throughout Ohio.

ImproveCareNow.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 95 care centers around the country 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 80 percent of patients are in clinical remission (feeling well and fully active), 90 percent have satisfactory nutrition, 93 percent have satisfactory growth and 94 percent are not taking steroids. Since 2007, remission rates have risen from 55 percent to 81 percent, without new medications. 

Learn more about ImproveCareNow.

IROC logo.The Improving Renal Outcomes Collaborative (IROC) currently includes 19 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.  The collaborative completed a design process by which it used design techniques to identify the key features of its quality improvement, research and patient and families engagement programs. IROC is building its IT infrastructure while its centers are undertaking QI fundamentals mandatory courses. Data entry in the registry is scheduled for March 2017.  

NPCQIC.The National Pediatric Cardiology Quality Improvement Collaborative (NPCQIC) includes 61 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 46 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, Transparency, Patient and Family Support.

Learn more about the National Pediatric Cardiology Quality Improvement Collaborative

Ohio Perinatal Quality Collaborative (OPQC).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 involves 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 has shifted more than 63,450 births to term and reduced bloodstream infections by 31 percent in very premature infants hospitalized in Ohio NICUs. OPQC’s NAS Project has increased compassionate care and reduced length of treatment and length of stay for the more than 7,000 infants treated for neonatal abstinence syndrome in Ohio since January 2014. OPQC has 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. OPQC continues to work with the five Medicaid managed care plans to identify additional women at risk for preterm birth. The NICU Graduates Project has completed design of a care transition and coordination plan for infants with complex conditions in the five Ohio Children’s Hospital NICUs and has started the testing and implementation phase. OPQC works with the Ohio Department of Health-Vital Statistics to offer and promote webinars and workshops educating clinicians and staff on the entry and maintenance of birth registry data in IPHIS. 

OPQC kicked off a new obstetrics project on long-action reversible contraception (LARC). This project is applying quality improvement strategies to increase the percentage of women who receive effective contraception at select FQHCs, with a specific focus on LARC. The larger aim of this project is to empower women, promote birth spacing, and reduce the rate of infant mortality in Ohio.

Learn more about the Ohio Perinatal Quality Collaborative.

Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) .The Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) began in 2011 and is a growing network of 17 North American rheumatology care centers focused on improving care and outcomes for children with potentially crippling conditions. In 2015, PR-COIN 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.

The objective of the Sickle Treatment and Outcomes Research in the Midwest (STORM) Learning Network is to build a sustainable collaborative network to improve the outcomes and care for patients with sickle cell disease (SCD) in the Midwest.  We are partnering with patients and families and the hematology and primary care communities. 

The STORM network consists of one practice-based team from each of six states (IL, IN, MI, MN, OH and WI) who are working to engage our regional partners.   

Learn more about STORM.

$8.8 Million Grant Supports Development of New Learning Networks

Cincinnati Children’s stature as a national leader in harnessing the power of learning networks to improve patient outcomes is demonstrated by a two-year $8.8 million grant by the Patient Centered Outcomes Research Institute (PCORI). The Anderson Center received this grant in 2017 to lead development of up to four new learning networks.

The grant reflects the growing national confidence that networks represent an important path toward a learning health system, says Peter Margolis, MD, co-director of the Anderson Center and principal investigator of ImproveCareNow.

Collaboration in Action

Erin Moore, parent, collaborator and blogger, wrote about her experience attending an active network’s Community Conference and the takeaways that she brought back to share with emerging networks.

“So what does all of this mean for CF? For starters, we're not starting at square one. ImproveCareNow and NPCQIC and SPS, all learning networks that have been developing and learning over the past many years have started to lay the tracks for us to ride upon. We can learn from what they have done and are doing, and model ourselves off of their success. ... We will stop wasting the precious time that we have in CF on solutions that have little impact, and focus our efforts on learning quality improvement and collaboration to transform outcomes.”

Read more about her experience and the power of Learning Networks on her blog.