Pediatric quality & safety最新文献

{"title":"Ensuring Timely Pulmonary Follow-up after an Inpatient Asthma Hospitalization: A Quality Improvement Initiative.","authors":"Leela Chandrasekar, Hollie Schaffer, Sanjiv Godse, Matthew Grossman, Laura Chen, Eliaz Brumer","doi":"10.1097/pq9.0000000000000815","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000815","url":null,"abstract":"<p><strong>Introduction: </strong>Timely outpatient follow-up after hospitalization for asthma exacerbation is essential for ongoing management and preventing future episodes. We identified significant variability in scheduling postdischarge pulmonology follow-up, leading to inconsistent care. This quality improvement initiative aimed to ensure at least 90% of patients admitted for an acute asthma exacerbation who had been seen by the pulmonology team scheduled for an outpatient pulmonary follow-up with an 80% attendance rate within 45 days of hospital discharge.</p><p><strong>Methods: </strong>A multidisciplinary team developed 3 key drivers. Key interventions included developing standardized asthma care guidelines and ensuring timely pulmonary consultation for all patients admitted to the pediatric intensive care unit with asthma exacerbation. The pulmonary team was also notified of patients previously seen by the department who were admitted to the floor for asthma exacerbation. The outcome measures included the percentage of patients admitted with asthma exacerbation scheduled for pediatric pulmonology follow-up appointments within 45 days and the percentage attending those appointments.</p><p><strong>Results: </strong>The percentage of scheduled appointments increased from 58.7% to 97.3%, and the appointment attendance rate improved from 45.3% to 85.2%. A retrospective review 3 years after the project's implementation showed sustained improvement, with 93% of appointments scheduled and 82.7% attended.</p><p><strong>Conclusions: </strong>Scheduling pulmonary follow-up appointments before discharge and using active reminders with immediate rescheduling of cancelations improved outpatient visit attendance. Further research is needed to confirm whether timely follow-up enhances asthma control and reduces readmissions.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e815"},"PeriodicalIF":1.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082536","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}

{"title":"Improving STI Screening in Adolescent and Young Adult Men in a Primary Care Setting.","authors":"Jessica Addison, Ramy Yim, Ben Ethier, Maria Alfieri, Lydia A Shrier, Allison Pellitier, Susan Fitzgerald, Gabriela Vargas, Josh Borus","doi":"10.1097/pq9.0000000000000807","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000807","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents and young adults (AYAs) account for approximately half of all new diagnoses of sexually transmitted infections (STIs) in the United States. Screening AYA men is imperative to stopping the spread of infection as well as preventing long-term sequelae. Although our AYA medical practice has consistently screened AYA women at rates more than 80% annually, the baseline screening rate for men was less than 70%.</p><p><strong>Methods: </strong>Between May 2021 and October 2023, we conducted a quality improvement initiative among male primary care patients older than 15 years who had an annual physical within the past 3 years. Interventions included adding a bathroom sign clearly stating urine would not be used for drug testing and creating and implementing a chlamydia and gonorrhea (GC/CT) testing alert in the electronic health record for all male medical visits. Our primary outcome was the percentage of patients who received GC/CT screening.</p><p><strong>Results: </strong>Statistical process control p-chart analysis showed special cause variation with improved GC/CT screening rates among AYA men in primary care, including a significant increase in the mean screening rate from 73.5% to 83.5% following our second intervention, demonstrating a mean shift from previous results.</p><p><strong>Conclusions: </strong>Clinic-level interventions-bathroom signage indicating urine would not be used for drug testing did not improve STI screening rates, whereas an electronic health record prompt for clinic staff regarding the need for STI testing-improved GC/CT screening rates among AYA men in primary care.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e807"},"PeriodicalIF":1.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082559","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}

{"title":"Reduction of Vancomycin Use in a Neonatal Intensive Care Unit: A Quality Improvement Project.","authors":"Sejal M Bhavsar, Erica B Casella, Maureen Kim, Patrick Lake, Sabrina Malik, Kaitlyn Philips, Pooja Shah, Shevaitha T Shyamalan, Stefan Hagmann","doi":"10.1097/pq9.0000000000000810","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000810","url":null,"abstract":"<p><strong>Introduction: </strong>Late-onset sepsis (LOS) is a common cause of neonatal morbidity and mortality. Professional organizations recommend avoiding empiric vancomycin use in neonates without risk factors for methicillin-resistant <i>Staphylococcus aureus</i> infection. We aimed to reduce the mean vancomycin antibiotic utilization rate (AUR) by 30% for 12 months in our neonatal intensive care unit (NICU).</p><p><strong>Methods: </strong>We included neonates admitted to our level-3 NICU from March 15, 2023, to February 29, 2024, with suspected LOS in the intervention period. A multidisciplinary team used the Model for Improvement. Interventions tested using plan-do-study-act cycles included provider education, clinical practice guideline (CPG) implementation, and prospective audit with feedback (PAF). The outcome measure was the mean vancomycin AUR measured in days of therapy per 1,000 patients days, plotted monthly and analyzed for special cause variation. The process measure was CPG adherence. We tracked balancing measures related to morbidity and mortality.</p><p><strong>Results: </strong>During the intervention period, 50 neonates underwent LOS evaluations. The mean vancomycin AUR decreased by 37.1%, from 27 to 17 days of therapy per 1,000 patient days, and was sustained postintervention. CPG adherence was 96%. Three neonates required changing from oxacillin to vancomycin for coagulase-negative staphylococci bacteremia (n = 2) and urinary tract infection (n = 1). There were no drug-related morbidity or sepsis-related mortality events.</p><p><strong>Conclusions: </strong>This quality improvement project allowed a safe, rapid and sustained reduction of NICU-wide vancomycin use. Provider education, CPG implementation, and PAF were critical to optimizing empiric antibiotic management.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e810"},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045045","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}

{"title":"A Standardized Approach to Reduce Fluid Overload in Critically Ill Children.","authors":"Andrew J Hopwood, Tina M Schade Willis, Michelle C Starr, Katie M Hughes, Stefan W Malin","doi":"10.1097/pq9.0000000000000813","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000813","url":null,"abstract":"<p><strong>Introduction: </strong>Fluid overload, the pathologic state of positive fluid balance, is common in the pediatric intensive care unit (PICU) and is independently associated with poor outcomes. Quality improvement-based processes to measure and assess fluid balance in critically ill children are lacking.</p><p><strong>Methods: </strong>The primary aim was to develop and implement a fluid management strategy that includes the standardized measurement and assessment of fluid balance, which is adhered to in at least 50% of all PICU patients. The 4 components of the strategy include (1) creating a fluid balance dashboard that tracks percent cumulative fluid balance over time, (2) documentation of daily weights, (3) fluid balance reporting and discussion incorporated into standardized rounds, and (4) active total intravenous (IV) fluid order.</p><p><strong>Results: </strong>We reviewed 280 patient encounters between May 2023 and April 2024 and achieved the primary aim of at least 50% compliance with the fluid management strategy and maintained this success over time. Achieving the primary aim coincides with implementing daily weights and total IV fluid orders into PICU admission order sets.</p><p><strong>Conclusions: </strong>In this quality improvement project, we develop, implement, and maintain compliance with a fluid management strategy. Future work will involve daily utilization of the fluid balance dashboard and monitoring compliance with total IV fluid orders. Implementing a quality improvement-based fluid management strategy may lead to improved awareness of the fluid status of patients and the prescription of fluid therapy to mitigate the harmful effects of fluid overload.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e813"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060685","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}

{"title":"Characteristics of Hot and Cold Debriefs for In-hospital Cardiac Arrest in the Pediatric Intensive Care Unit: A Mixed-methods Analysis.","authors":"Brennan Donville, Heather Wolfe, Ken Tegtmeyer, Matthew Zackoff, Maria Frazier, Daniel Loeb, Andrew Lautz, Amanda O'Halloran, Maya Dewan","doi":"10.1097/pq9.0000000000000812","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000812","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined a standardized event review approach, assessing hot and cold debriefs in pediatric in-hospital cardiac arrest (IHCA) to demonstrate their distinct but synergistic values.</p><p><strong>Methods: </strong>This retrospective mixed-methods analysis was conducted for 2 years in a large, single-center pediatric intensive care unit (PICU) at a quaternary care, free-standing children's hospital. Following the standardization of debriefing processes, both hot and cold debriefs were systematically performed after PICU IHCA events where chest compressions lasted longer than 1 minute, utilizing standardized debrief forms. Event-level data were collected for each IHCA, with the possibility of patients being represented multiple times.</p><p><strong>Results: </strong>There were 37 recorded PICU IHCAs during the study period from March 2020 to April 2022. Hot debriefs were performed in 84% (31/37) of events, and cold debriefs in 100% (37/37). Qualitative analysis of hot debriefs found that issues with communication and personnel (25%), cardiopulmonary resuscitation quality (25%), and medication preparation/administration (23.7%) were most cited. Analysis of cold debrief comments revealed that patient care (42.2%), environment and compliance (28.9%), and communication (20%) were the 3 most cited areas of potential improvement.</p><p><strong>Conclusions: </strong>Hot and cold debriefs following pediatric IHCA are both feasible and clinically valuable. The combined use of these debriefing tools provided more comprehensive insights, with each format uniquely contributing to identifying distinct areas for improvement. Additionally, our findings highlight the importance of a carefully crafted and standardized approach to debriefing that aligns with the intended outcomes.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e812"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060106","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}

{"title":"The Nationwide Children's Hospital Blood and Marrow Transplant Index: A Quality Improvement Approach to Assess the Performance of a Pediatric Blood and Marrow Transplant Program.","authors":"Rolla F Abu-Arja, Nabanita Bhunia, Lubna Mehyar, Joseph Stanek, Jason Moore, Courtney Kirby, Randal Olshefski, Vilmarie Rodriguez, Hemalatha G Rangarajan","doi":"10.1097/pq9.0000000000000811","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000811","url":null,"abstract":"<p><strong>Introduction: </strong>To design and test a metric that reflects the overall quality and safety performance of our blood and marrow transplant program (BMT) and use this metric to enhance the quality of care provided to patients.</p><p><strong>Methods: </strong>The BMT index (BMTI) aggregates safety events and missed opportunities for best practices into a composite score that reflects the overall clinical performance of the BMT program, irrespective of the type of transplant or patient outcome. We selected 13 domains and divided them based on the time in the transplant continuum. The BMT journey has 3 general spheres: (1) the pretransplant, (2) the transplant admission, and (3) the posttransplant follow-up and long-term care. The BMTI represents the total count of adverse safety events or missed opportunities to deliver quality care within a given period within these domains. In this regard, lower aggregate BMTI scores reflect higher quality care and improved overall systems performance.</p><p><strong>Results: </strong>The BMTI was easy to calculate and monitor. The annual BMTI aggregate score progressively decreased from a baseline of 133 in year 1 to 35 in year 3 (73.68% reduction), leading to a follow-up version of the BMTI that addressed new domain measures and achieved sustained mode.</p><p><strong>Conclusions: </strong>The BMTI is a valuable metric for monitoring the efficiency of the BMT service quality improvement initiatives. This concept applies to other programs. Specifically, the index documented the ability to improve the quality of patient care and provide consistent, evidence-based care.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e811"},"PeriodicalIF":1.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053053","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}

{"title":"A Quality Improvement Initiative to Improve Normothermia While Transitioning Premature Infants to an Open Crib.","authors":"Nadia Campbell, Austin Han, Ranjith Kamity, Amrita Nayak","doi":"10.1097/pq9.0000000000000809","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000809","url":null,"abstract":"<p><strong>Introduction: </strong>Current literature focuses on the optimal lowest weight and incubator temperature to transition an infant to an open crib, with minimal data quantifying the rate of failed attempts or standardizing the process. Due to multiple failed attempts at this institution in 2021, the project aimed to reduce the rate of preterm newborns who failed the crib by 10% in 1 year.</p><p><strong>Methods: </strong>Interventions, including nursing education, an audit checklist, environmental changes, and a standardized protocol, were implemented after establishing baseline data.</p><p><strong>Results: </strong>The incidence of failed transitions to an open crib decreased from a baseline of 13.5% failed cribs per monthly transition attempts to 3.3% failed cribs per monthly transition attempts in 18 months, a 76% decrease, where it is currently sustained. Of note, infants born between 32 and 35 weeks gestation had higher failure rates compared with those born <32 weeks.</p><p><strong>Conclusions: </strong>Compliance with a thermoregulation protocol, utilizing an audit checklist, and standardizing the process improved the success rate of transitioning to an open crib.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e809"},"PeriodicalIF":1.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054394","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}

{"title":"Pediatric Emergency Department Burn Discharge and Clinic Readiness: A Quality Improvement Project.","authors":"Rachel Hatcliffe, Anne Ciriello, Elizabeth Murphy Waibel, Cindy Colson, Ashley White, Jennifer Fritzeen, Sarah Isbey","doi":"10.1097/pq9.0000000000000806","DOIUrl":"https://doi.org/10.1097/pq9.0000000000000806","url":null,"abstract":"<p><strong>Introduction: </strong>The shift to outpatient care for pediatric burn injuries has placed a greater responsibility on caregivers for wound care and follow-up planning. Nonadherence to burn care and follow-up appointments can lead to negative emotional and physical health outcomes. Both parental education and pain control with dressing changes are important factors for adherence to outpatient care. This single-center quality improvement project aimed to improve pediatric burn patients discharged from the emergency department with the correct instruction packet and the percentage of qualifying patients prescribed oxycodone for premedication for their initial clinic appointment.</p><p><strong>Methods: </strong>A multidisciplinary team retrospectively examined barriers using a fishbone diagram, developed a key driver diagram, and designed interventions, including updated custom instructions, printed discharge pamphlets, electronic medical record changes, enhanced e-prescribing access, linked International Classification of Diseases, Tenth Revision codes, targeted provider feedback, and education sessions. We tracked monthly data using statistical process control charts.</p><p><strong>Results: </strong>At baseline, 46% of patients received the correct discharge packet; following interventions, we observed a centerline shift to 78% with sustained improvement. Seventy percent of qualifying patients received an oxycodone prescription for premedication before clinic follow-up at baseline, and we saw a sustained baseline shift to 93% after interventions.</p><p><strong>Conclusions: </strong>Following multiple targeted interventions, there was a sustained improvement in the use of a custom burn discharge instruction packet and oxycodone prescriptions. Future research should examine the impact of discharge instructions and oxycodone prescriptions on the timeliness of outpatient appointment scheduling and pain scores.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"10 3","pages":"e806"},"PeriodicalIF":1.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057998","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}

{"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}

{"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}