Pediatric quality & safety最新文献

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Enhancing Safety in Mechanical Ventilation: A Quality Improvement Initiative Targeting Unplanned Extubations in a Tunisian PICU.
IF 1.2
Pediatric quality & safety Pub Date : 2025-04-02 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000805
Farah Thabet, Seyfeddine Zayani, Abir Daya, Chokri Chouchane, Slaheddine Chouchane
{"title":"Enhancing Safety in Mechanical Ventilation: A Quality Improvement Initiative Targeting Unplanned Extubations in a Tunisian PICU.","authors":"Farah Thabet, Seyfeddine Zayani, Abir Daya, Chokri Chouchane, Slaheddine Chouchane","doi":"10.1097/pq9.0000000000000805","DOIUrl":"10.1097/pq9.0000000000000805","url":null,"abstract":"<p><strong>Background: </strong>Unplanned extubation (UE) in pediatric intensive care units (PICUs) is a critical adverse event that can lead to severe complications, including respiratory distress and hypoxia. This study aimed to reduce UE incidence among mechanically ventilated children by implementing targeted quality improvement interventions.</p><p><strong>Methods: </strong>A quality improvement initiative was conducted in a 7-bed PICU at a university-affiliated hospital in Tunisia from January 2022 to December 2023. The study included three phases: baseline assessment, intervention implementation, and postintervention evaluation. Approaches for improvement included using a key driver diagram and Pareto analysis which led to interventions such as standardized endotracheal tube (ETT) fixation procedures, sedation management, and staff training. The outcome was monitored using statistical process control methods, particularly a U chart to track UE rates.</p><p><strong>Results: </strong>Following the implementation of the quality improvement interventions, the UE rate decreased from 3.62 to 2.06 per 100 ventilation days, a 42.7% reduction (<i>P</i> = 0.015). Statistical process control analysis indicated a statistically significant shift, confirming the effectiveness of the interventions.</p><p><strong>Conclusions: </strong>Targeted quality improvement interventions, including standardized protocols and staff training, significantly reduced the incidence of UEs in the PICU. These findings underscore the importance of continuous improvement efforts in enhancing patient safety in resource-limited settings.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e805"},"PeriodicalIF":1.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Initiating Insulin Pumps in Youth with New-onset Type 1 Diabetes: A Quality Improvement Initiative.
IF 1.2
Pediatric quality & safety Pub Date : 2025-03-19 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000803
Mili Vakharia, Sarah K Lyons, Don Buckingham, Mark Rittenhouse, Siripoom McKay, Rona Sonabend, Grace Kim
{"title":"Initiating Insulin Pumps in Youth with New-onset Type 1 Diabetes: A Quality Improvement Initiative.","authors":"Mili Vakharia, Sarah K Lyons, Don Buckingham, Mark Rittenhouse, Siripoom McKay, Rona Sonabend, Grace Kim","doi":"10.1097/pq9.0000000000000803","DOIUrl":"10.1097/pq9.0000000000000803","url":null,"abstract":"<p><strong>Introduction: </strong>Insulin pump therapy is recommended for youth with type 1 diabetes (T1D) as it enhances quality of life and improves glycemic management. We led a quality improvement initiative to increase insulin pump use in youth younger than 18 years of age with recently diagnosed T1D (duration <1 y) from a baseline of 17% to 27% from January 2021 to December 2023. As a balancing measure, we evaluated the diabetes-related ketoacidosis (DKA) rate in the same cohort as nonpump users.</p><p><strong>Methods: </strong>We implemented the following plan-do-study-act cycles: (1) development and implementation of pump initiation algorithm, including minimal safe start criteria and education on ketosis management with pump action plan, (2) establishing clinic follow-up within 90 days of pump start, (3) expansion of the pump algorithm at additional clinic locations, (4) early patient/caregiver education about pumps at a clinic visit 2 weeks after diagnosis, and (5) insulin pump therapy workshop for staff and providers.</p><p><strong>Results: </strong>There was a centerline shift in the percentage of patients with recently diagnosed T1D on insulin pumps from 17% to 28% from January 2021 to December 2023. We also found no pumps-related DKA encounters amongst patients with recently diagnosed T1D.</p><p><strong>Conclusions: </strong>Our improvement efforts increased pump usage in our cohort without related DKA events. A multidisciplinary approach with education on managing pumps should be implemented to prevent shortcomings such as DKA. Future directions are to evaluate HbA1c and pre-pump and post-pump DKA rates.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e803"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increasing Academic Output through Quality Improvement Educational Strategies.
IF 1.2
Pediatric quality & safety Pub Date : 2025-03-13 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000804
Hannah Stuart, Sangeeta Schroeder, Abbey Studer, Derek Wheeler, Jennifer Lavin, Caitlin Naureckas Li
{"title":"Increasing Academic Output through Quality Improvement Educational Strategies.","authors":"Hannah Stuart, Sangeeta Schroeder, Abbey Studer, Derek Wheeler, Jennifer Lavin, Caitlin Naureckas Li","doi":"10.1097/pq9.0000000000000804","DOIUrl":"10.1097/pq9.0000000000000804","url":null,"abstract":"<p><strong>Introduction: </strong>Quality improvement (QI) work is imperative to support health systems in providing safe and effective care. Conflicting demands, including the need to complete standard work recognized for academic promotion, can hinder meaningful participation in QI work.</p><p><strong>Methods: </strong>At our quaternary pediatric hospital, we completed a series of plan-do-study-act cycles around developing QI educational opportunities. Our outcome measure was the number of publications containing the phrase \"Quality Improvement\" with at least 1 author from our institution. Our process measures included the cumulative number of employees trained in QI methods or writing.</p><p><strong>Results: </strong>The number of publications increased significantly from an average of 3.4 to 12.5 per quarter. The total number of employees trained in QI methods and QI writing increased throughout the study period.</p><p><strong>Conclusions: </strong>A series of interventions designed to increase the QI fluency of our workforce were associated with an increase in the number of QI publications at our institution.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e804"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advocating for Our Children: An Initiative Utilizing Verbal and Video Education to Increase Adverse Childhood Experiences Questionnaire Form Response Rate. 为我们的孩子代言:利用口头和视频教育提高童年不良经历调查表回复率的倡议。
IF 1.2
Pediatric quality & safety Pub Date : 2025-03-06 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000801
Madison R Tyle, Shainal Gandhi, Nikhita Nookala, Kelly A Campbell, Melissa Chow, Marilyn Torres, Sarah A Commaroto, Monica Khadka, Emily Coughlin, Vinita Kiluk
{"title":"Advocating for Our Children: An Initiative Utilizing Verbal and Video Education to Increase Adverse Childhood Experiences Questionnaire Form Response Rate.","authors":"Madison R Tyle, Shainal Gandhi, Nikhita Nookala, Kelly A Campbell, Melissa Chow, Marilyn Torres, Sarah A Commaroto, Monica Khadka, Emily Coughlin, Vinita Kiluk","doi":"10.1097/pq9.0000000000000801","DOIUrl":"10.1097/pq9.0000000000000801","url":null,"abstract":"<p><strong>Introduction: </strong>Negative experiences in childhood, Adverse Childhood Experiences, significantly increase the risk of adverse health outcomes in adulthood. Obtaining a better understanding of the experiences a child has been through during development allows providers to connect them with resources to improve health outcomes.</p><p><strong>Methods: </strong>We performed problem identification via PubMed and the Florida Department of Health web page. We used the plan-do-study-act (PDSA) quality improvement method. Intervention one involved teaching clinic staff about distributing the Adverse Childhood Experiences Questionnaire (ACE-Q) form during well-check visits. Intervention two involved a video education tool to explain the purpose and importance of the ACE-Q to caretakers. We conducted a retrospective chart review at the 17 Davis and HealthPark clinics 3 months preceding each PDSA cycle. We analyzed the data to assess the response rate to the ACE-Q before and after each cycle.</p><p><strong>Results: </strong>The educational initiatives increased the response rate to the ACE-Q form in both PDSA cycles. The ACE-Q was significantly more likely to be filled out after the first (19.2% in pre versus 24.8% in post, <i>P</i> < 0.001) and second PDSA cycles (15% in pre versus 45.2% in post, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Verbal and video education models can increase the response rate to the ACE-Q. Response collection is valuable for identifying and supporting patients at the highest risk for poor health outcomes. Future studies would benefit from addressing low view counts on video interventions, standardizing ACE-Q score assessment, and implementing sustainable measures.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e801"},"PeriodicalIF":1.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Letter to Our Reviewers- the Core of Pediatric Quality and Safety.
IF 1.2
Pediatric quality & safety Pub Date : 2025-03-05 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000795
Richard J Brilli, Richard Eugene McClead, Ryan S Bode, Robert Gajarski, David C Stockwell
{"title":"A Letter to Our Reviewers- the Core of <i>Pediatric Quality and Safety</i>.","authors":"Richard J Brilli, Richard Eugene McClead, Ryan S Bode, Robert Gajarski, David C Stockwell","doi":"10.1097/pq9.0000000000000795","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000795","url":null,"abstract":"","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e795"},"PeriodicalIF":1.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Quality Improvement Project to Promote Interdisciplinary Communication Using the Pediatric Early Warning System.
IF 1.2
Pediatric quality & safety Pub Date : 2025-03-03 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000800
Jan Fune, Angie Buttigieg, Srividya Bhadriraju, Rachel Moss, Laura N Hodo
{"title":"A Quality Improvement Project to Promote Interdisciplinary Communication Using the Pediatric Early Warning System.","authors":"Jan Fune, Angie Buttigieg, Srividya Bhadriraju, Rachel Moss, Laura N Hodo","doi":"10.1097/pq9.0000000000000800","DOIUrl":"10.1097/pq9.0000000000000800","url":null,"abstract":"<p><strong>Introduction: </strong>In August 2020, residents and nurses lacked awareness and knowledge of the pediatric early warning system (PEWS). Residents and nurses infrequently performed interdisciplinary bedside huddles for patients with critical scores, and residents did not document assessments and plans despite these patients being at higher risk for clinical deterioration. We aimed to increase the mean rate of documented huddles from 0% to 50% within 4 months.</p><p><strong>Methods: </strong>We piloted this quality improvement project on 1 floor of a pediatric hospital and included patients admitted to the pediatric hospital medicine service. Key drivers included buy-in and trust in PEWS, understanding of critical scores, a reliable scoring algorithm, and a culture where interdisciplinary communication is routine. Interventions included physician and nurse education, improving the scoring algorithm, and promoting a shared understanding of PEWS. Our outcome measure was the percentage of documented huddle notes for each patient with a critical score, a proxy for huddles occurring. We entered data into a control chart and analyzed it for changes in response to interventions.</p><p><strong>Results: </strong>The mean baseline rate of note completion was 0%. After 4 months, the mean increased to 100%, associated with multiple educational interventions and efforts to improve the scoring algorithm.</p><p><strong>Conclusions: </strong>Implementing multimodal interventions was associated with an increased rate of documented huddles. Scoring algorithm changes and personalized education galvanized physician and nurse support for PEWS. Institutions can use the lessons we have learned to implement PEWS and promote huddles and interdisciplinary communication.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e800"},"PeriodicalIF":1.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Postpartum Depression Screening Rates Using a Quality Improvement Framework in a Community-based Academic Primary Care Clinic.
IF 1.2
Pediatric quality & safety Pub Date : 2025-02-28 eCollection Date: 2025-03-01 DOI: 10.1097/pq9.0000000000000802
Alexandra Epee-Bounya, Elizabeth Mari, Jahmakah-Lynn Seals, Shannon Regan, Corinna J Rea
{"title":"Improving Postpartum Depression Screening Rates Using a Quality Improvement Framework in a Community-based Academic Primary Care Clinic.","authors":"Alexandra Epee-Bounya, Elizabeth Mari, Jahmakah-Lynn Seals, Shannon Regan, Corinna J Rea","doi":"10.1097/pq9.0000000000000802","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000802","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal postpartum depression (PPD) is the most common diagnosis during the postpartum period, with a higher incidence in underserved populations. Though PPD often goes undiagnosed, prompt diagnosis has a positive impact on several measures of children's health and development, as well as maternal health. To increase routine screening per American Academy of Pediatrics recommendations, we implemented a multipronged quality improvement (QI) initiative centered around a newborn coordinator embedded in our primary care clinic.</p><p><strong>Methods: </strong>A multidisciplinary team implemented a QI initiative in a community-based academic primary care clinic. We used the plan-do-study-act method and other QI tools to improve our processes and p-type control charts to monitor improvements. The interventions centered on workflow changes and staff education with aims to increase our PPD screening rates to 75%, maintain appropriate referral rates for parents with positive PPD screeners above 90%, and ensure no disparity in rates of screening regardless of race/ethnicity, language, and insurance status.</p><p><strong>Results: </strong>PPD screening rates for all well child care visits from birth to age 6 months increased from a mean of 16 % at baseline to 72%. Additionally, we maintained a referral rate for positive PPD screens above 90%. Our health equity analysis did not demonstrate any disparity in our screening rates.</p><p><strong>Conclusions: </strong>Applying a combination of education and process workflow changes can successfully increase screening rates for PPD in a community-based academic primary care clinic.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 2","pages":"e802"},"PeriodicalIF":1.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Adherence to the Lead Exposure Protocol at Boston Medical Center's Pediatric Clinic.
IF 1.2
Pediatric quality & safety Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000793
Julie R Barzilay, Anthony J Mell, MaryKate Driscoll, Priscilla Gonzalez, Sarah Meyers, Noah Buncher
{"title":"Improving Adherence to the Lead Exposure Protocol at Boston Medical Center's Pediatric Clinic.","authors":"Julie R Barzilay, Anthony J Mell, MaryKate Driscoll, Priscilla Gonzalez, Sarah Meyers, Noah Buncher","doi":"10.1097/pq9.0000000000000793","DOIUrl":"10.1097/pq9.0000000000000793","url":null,"abstract":"<p><strong>Introduction: </strong>Using plan-do-study-act cycles, our team aimed to increase mean provider adherence to the Lead Exposure Protocol at the Boston Medical Center Pediatric Primary Care Clinic from 16% (baseline global mean provider adherence) to 80% from April 1, 2021, to February 1, 2023, thereby curbing the secondary effects of lead exposure.</p><p><strong>Methods: </strong>Our team performed a chart review of patients 6 months to 5 years of age with blood lead levels (BLLs) ≥2 µg/dL (n = 853) to track provider adherence to Boston Medical Center's Lead Exposure Protocol. We created p charts to track the efficacy of interventions to improve adherence. Interventions included (1) electronic medical record SmartPhrases, (2) provider education, (3) provider feedback, (4) implementation of a follow-up nursing workflow, and (5) simplification of nursing workflow.</p><p><strong>Results: </strong>For BLL 2-4 µg/dL (n = 783), a centerline shift in provider adherence was observed, with >8 points above the preintervention mean after intervention (2) and an increase in mean adherence from 14.1% to 50%. For BLL 5-9 µg/dL (n = 58), no centerline shift was observed, with only 6 points above the upper control limit after intervention (4). The 2-4 µg/dL range changes indicate special cause variance and system change. Global mean provider adherence increased by 3.3 times to 53%.</p><p><strong>Conclusions: </strong>Simple, low-cost process changes improved adherence to complex guidelines for managing lead-exposed children in the primary care setting. Similar interventions could be implemented on a broader scale to standardize the management of other routine pediatric screens.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e793"},"PeriodicalIF":1.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leveraging Quality Improvement Tools to Improve Administration of First-line Surgical Antibiotic Prophylaxis in Patients Labeled as Penicillin Allergic.
IF 1.2
Pediatric quality & safety Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000794
Madeline Mock, David Morris, Jessica Foley, Mellissa Mahabee, J Michael Klatte, Beth Williams, Daniel Robie
{"title":"Leveraging Quality Improvement Tools to Improve Administration of First-line Surgical Antibiotic Prophylaxis in Patients Labeled as Penicillin Allergic.","authors":"Madeline Mock, David Morris, Jessica Foley, Mellissa Mahabee, J Michael Klatte, Beth Williams, Daniel Robie","doi":"10.1097/pq9.0000000000000794","DOIUrl":"10.1097/pq9.0000000000000794","url":null,"abstract":"<p><strong>Introduction: </strong>A reported penicillin allergy reduces the likelihood that the patient will receive first-line surgical antibiotic prophylaxis (SAP), which can increase the risk of developing a surgical site infection (SSI). This project aimed to increase the use of first-line SAP agents in orthopedic and pediatric surgery patients with a reported penicillin allergy.</p><p><strong>Methods: </strong>The Institute for Healthcare Improvement quality improvement methodology was followed. Key drivers included patient and family awareness of true penicillin allergies, standardization for ordering antibiotics, staff buy-in, electronic medical record utilization, and staff comfort with ordering first-line SAP. Initial plan-do-study-act cycles focused on provider education. Subsequent plan-do-study-act cycles focused on the antibiotic delivery process, antibiotic selection, screening tool development for severe delayed hypersensitivity reactions, education, and data transparency. The outcome measure was the percentage of orthopedic and pediatric surgery patients with a reported penicillin allergy that received first-line SAP per month.</p><p><strong>Results: </strong>Since the start of the project in December 2022, there were 2 statistically significant changes in the outcome measure's mean, shifting the mean from 25% to 84% in orthopedic and pediatric surgery patients with a reported penicillin allergy who received first-line SAP. There were no adverse medication reactions and no statistically significant change in SSIs.</p><p><strong>Conclusions: </strong>The mean has been at 84% for 9 months showing a sustainable process and culture change regarding first-line SAP usage for orthopedic and pediatric surgery patients. This was achieved through targeting the antibiotic delivery processes without relying on hard stops within the medical record.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e794"},"PeriodicalIF":1.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Evidenced-based Outpatient Order Set Utilization in the Gastrointestinal Division of a Large Pediatric Health System.
IF 1.2
Pediatric quality & safety Pub Date : 2025-01-23 eCollection Date: 2025-01-01 DOI: 10.1097/pq9.0000000000000792
Kevin L Watson, April M Love, Hanna Lemerman, Cathy Gustaevel, Prabi Rajbhandari
{"title":"Improving Evidenced-based Outpatient Order Set Utilization in the Gastrointestinal Division of a Large Pediatric Health System.","authors":"Kevin L Watson, April M Love, Hanna Lemerman, Cathy Gustaevel, Prabi Rajbhandari","doi":"10.1097/pq9.0000000000000792","DOIUrl":"10.1097/pq9.0000000000000792","url":null,"abstract":"<p><strong>Introduction: </strong>Standardization is crucial in improving healthcare outcomes, equity and quality. Clinical decision support tools are key to achieving this goal. At our organization, Epic serves as our electronic health record, and SmartSets are Epic's version of outpatient standardized order sets with embedded clinical decision support tools. In 2022, the utilization of SmartSets in our hospital's gastrointestinal division was only 1.9%, far below our organizational target of 50%.</p><p><strong>Methods: </strong>Our group formed a quality improvement (QI) team and chose the model for improvement methodology. The interventions focused on education, buy-in, feedback performance monitoring, and the enhancement and development of new SmartSets. Our primary aim was to increase the utilization rate of SmartSets by gastrointestinal providers from 1.9% to 20%, and our secondary aim was to reduce the time spent by providers on orders by 10% from 3.3 to 2.8 minutes per encounter. Our balancing measure was monitoring safety reports during the study period.</p><p><strong>Results: </strong>SmartSet utilization improved to greater than 20% within 7 months of the project initiation. Three months after implementing SmartSet updates and introducing new SmartSets into production, time spent on orders during clinical encounters decreased from a median of 3.3 to 2.4 minutes per encounter. We appreciated that there was no change in safety reporting during the project timeline.</p><p><strong>Conclusions: </strong>We achieved our goal of improving utilization rates of standardized SmartSets and reducing time spent on orders using a QI methodology. Our achievements underscore the effectiveness of QI methods in enhancing SmartSet utilization and streamlining order processes.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 1","pages":"e792"},"PeriodicalIF":1.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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