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Safety at the center: Quality team explains their role in delivering the best care for kids
February 05, 2021
Safety at the center: Quality team explains their role in delivering the best care for kids

Quality and Safety team explains their role in delivering the best care for kids

Clinicians in the health care setting are tasked with two monumental and overarching goals – 1) provide optimal care and 2) do no harm. While this may seem straightforward, to do these things well requires coordinated effort and analysis behind the scenes. That’s why we have a team dedicated to ensuring we’re providing care that is timely, effective and efficient – AND that we’re among the safest hospitals in the country for kids.

Our quality and safety team — also called the improvement science and analytics team – provides some insight into the role they play and why they’re so passionate about it.

Why are quality and safety initiatives so important?

Quality improvement work ensures we get the best outcomes for patients. We want them to get better so they can go home and get back to doing the fun things kids love to do. This forces us to be intentional about always improving.

These initiatives also allow us to track progress against internal benchmarks, as well in comparison to other children’s hospitals throughout the nation. Then, we can take an honest look at where we are today and determine what we may need to do to get better.

Who is on the CHoR quality team?

The clinical leaders across CHoR have always had an eye on quality, but they didn’t have the time and expertise across the board to give it the attention it deserves. With a dedicated quality and safety team, a triad approach of physician/nurse/administrative professional allows fresh yet focused lenses into efforts in all areas.

The improvement science and analytics team members include:

  • Michelande Ridoré, MS – quality manager
  • Kara Heird, RN – performance improvement coordinator
  • Erika Liptrap – business intelligence analyst
  • Jeremy Santoro, RD – clinical quality analyst

They partner with quality and safety leaders:

Although this team is dedicated to QI, everyone at CHoR has a responsibility for quality and safety.

What are some of the current quality projects underway at CHoR?

quality and safety team at CHoRThe quality team works closely with clinicians throughout CHoR to identify key initiatives. QI efforts are always evolving and growing. Here’s a snapshot of some of our current focus areas:

  • Enhancing communication between nurses and resident physicians in acute care
  • Reducing occurrence of:
    • Unplanned extubation (removal of breathing tubes) in the NICU and PICU
    • CLABSI (central line-associated blood stream infection) in all units
    • CAUTI (catheter-associated urinary tract infection) in all units
    • Pressure injury in the PICU
    • Hospital-acquired infection
  • Developing a formal and streamlined way for clinicians to call child life in as a resource to help with procedures and hospital stays
  • Working with CHoR leaders to continuously monitor the safety of our hospitals and clinics, making improvements that keep our patients, families and team members safe

How do we share quality and safety outcomes with the community? Why is this important?

Transparency is an important part of what we do. We want our community to know how we’re working to deliver safe and high-quality care for kids and families. There’s a section on our website that details initiatives and outcomes in various areas. We also have clinical quality improvement experts who share their work through community programs, such as Dr. Michael Schechter’s UCAN asthma program.

We share our work with the medical community through presentations, manuscripts and involvement in Virginia Children’s Care Network – a clinically-integrated network designed to improve the health of Virginia’s children through collaboration and quality improvement initiatives.

Do quality efforts have a report card? How do we track progress?

We have an internal scorecard where we track progress on key quality and safety priorities health system wide. This keeps us accountable to our leadership and board and, ultimately, to our patients as well.

The biggest external “report card” is the U.S. News & World Report best children’s hospitals rankings, which benchmarks us across other hospitals in specialty-specific markers. In 2020, we ranked among the nation’s best in four specialties.

Have we received any other recognition for our quality efforts?

Most of our recognition has come in the form of acceptance for presentations or publications so we can share our successful work with other clinicians throughout the country. This allows us to advance our goal of enhancing care for ALL children. Our physicians and nurses have recently presented or been published for quality improvement efforts in the areas of:

  • Asthma
  • Cystic fibrosis
  • Pain management
  • Reducing unnecessary care
  • Sepsis
  • Sickle cell disease
  • Stroke
  • Unplanned extubation

What inspired you to focus on quality?

Michelande: One of the first projects I worked on in my career was in a NICU. I realized that you can influence real-time improvements for patients without being a clinician – both analytically and team-based – to get them out of the hospital and into their parents’ arms faster.

Kara: For me it was learning about the California Maternal Quality Care Collaborative – a project in California focused on improving the maternal mortality rate. It was amazing to see how effort and coordination can make what seems impossible possible.

Jeremy: I was in a clinical role prior to joining the quality and safety team. I liked the ability to impact a significantly higher number of patients and families than you can clinically. We can positively influence hundreds of thousands of kids and family members through these efforts.

Erika: My passion for quality started back when I first joined the health system on the transplant team. We were very focused on outcomes data for CMS reporting. I correlated the data with the impact being made on real peoples’ lives.

Dr. Schefft: I love that QI is a team sport! We all have the same goal of keeping kids safe and doing the best we can for them.

Jeff (administrative intern): I’m a student in the Master of Health Administration program at VCU. Being part of this team allows me to see how many lives are impacted, and the focus on quality affects so many people across the health system in its entirety.

Ella (administrative intern): I always wanted to be in a clinical field, but it’s not necessarily a strong suit of mine. QI gives me the ability to have an impact on patients and families even though I’m not at the bedside, which is really inspiring.

Find out more about CHoR’s approach to ensuring patient-centered care through quality and safety initiatives.

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