Pediatric quality & safety最新文献

{"title":"Optimizing Nutrition in Pediatric Burn Patients: A Quality Improvement Initiative.","authors":"Tamara O Sharf, Mary S Kim, Dylan W Arkowitz, Elizabeth M Waibel, Jonathan M Teets, Samantha Schug, Elizabeth C Elliott, Matthew P Sharron, Randall S Burd","doi":"10.1097/pq9.0000000000000918","DOIUrl":"10.1097/pq9.0000000000000918","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric burn patients require up to twice their basal nutritional needs for healing and growth. Perioperative fasting is a modifiable source of nutritional interruption. Recent investigations show that liberalized feeding protocols do not increase aspiration risk. This study aimed to identify and mitigate nutritional barriers in operative pediatric burn patients.</p><p><strong>Methods: </strong>A multidisciplinary team identified key drivers of prolonged fasting. A standardized protocol was implemented using concentrated feeding formulas, continuing enteral feeds through procedures in intubated patients, and allowing high-protein clear liquids for up to two hours preoperatively in nonintubated patients. Primary outcomes included preoperative fasting duration and caloric and protein intake. Secondary outcomes included length of stay and perioperative complications.</p><p><strong>Results: </strong>Thirty patients were included (15 baseline and 15 intervention). Statistical process control analysis showed sustained reduction in preoperative fasting duration following protocol implementation. Among patients receiving tube feeding, median nil per os duration decreased from 11-hour baseline to 5.6 hours (<i>P</i> < 0.001), whereas caloric and protein intake increased (both <i>P</i> < 0.001). When adjusted for surgical start time and feeding modality, intervention status was associated with shorter fasting duration and increased caloric and protein delivery. No aspiration events occurred.</p><p><strong>Conclusions: </strong>Perioperative fasting is a contributor to nutritional outcomes in pediatric burn patients. A quality improvement initiative reduced fasting durations and improved perioperative caloric and protein delivery without increasing aspiration risk, impacting length of stay, or increasing perioperative complications. This approach is feasible in centers with varying resources and may be adapted to other pediatric surgical populations.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e918"},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026705","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":"Increasing Rates of Health-related Social Needs Screening in a Pediatric Critical Care Setting Through Quality Improvement.","authors":"Hemen Muleta, Camilo Pardo, Amanda Klafter, Susan Velasco, Renee Whiskey-LaLanne, Henry M Ushay, Patricia Hametz, Kevin P Fiori, Gina Cassel-Choudhury","doi":"10.1097/pq9.0000000000000932","DOIUrl":"10.1097/pq9.0000000000000932","url":null,"abstract":"<p><strong>Introduction: </strong>Prior research has linked health-related social needs (HRSNs) with poor pediatric health outcomes. Studies have demonstrated the implementation of HRSN screening in lower-acuity settings, but few have been conducted in pediatric intensive care units (PICUs). Our primary aim was to increase HRSN screening from 4% to 75% between February 2024 and May 2025. Our secondary aim was to increase referral rates for community health workers (CHW) from 0% to 75% for those with unmet HRSNs.</p><p><strong>Methods: </strong>A multidisciplinary team used quality improvement (QI) methodology to implement interventions in a 26-bed PICU at an urban, tertiary-care children's hospital. The study included all patients admitted to the PICU. We implemented six interventions over multiple plan-do-study-act cycles to optimize screening and CHW resource navigation workflow.</p><p><strong>Results: </strong>Data collection included sociodemographic characteristics and monthly HRSN screening completion, positive screens, and CHW referral rates. During our intervention period, there were 1,256 direct admits to the PICU. By the end of the study period, an average of 76% of patients had a completed HRSN screen, just over our anticipated goal. The mean HRSN screening increased from a baseline of 17.9% to 76.5. Among screened patients, 27.7% reported ≥1 unmet HRSN, with a mean CHW referral rate of 64%.</p><p><strong>Conclusions: </strong>A multidisciplinary team approach and use of QI methodology led to an increase in monthly HRSN screenings in our PICU. Next steps will focus on increasing CHW referral rates and connecting patients with resources for unmet HRSNs.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e932"},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026753","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 Project to Increase Discharges before Noon at a Pediatric Hospital.","authors":"Karen C Willis, Samantha M Gunkelman, Brittany K Potts, Kerwyn C Jones, Angela M Contant, Karan R Johnson, Prabi Rajbhandari","doi":"10.1097/pq9.0000000000000910","DOIUrl":"10.1097/pq9.0000000000000910","url":null,"abstract":"<p><strong>Introduction: </strong>Delays in patient discharges lead to inefficient hospital throughput and reduced access to care. The aim of this quality improvement (QI) project was to increase the percentage of discharge orders placed before noon (DOBN) by the pediatric hospital medicine (PHM) service from 27% to 32% between January 1, 2021, and December 31, 2022.</p><p><strong>Methods: </strong>We convened a multidisciplinary team of hospitalists, residents, nurses, and bed management staff and surveyed key stakeholders to identify the most important barriers. Key interventions included the implementation of a multidisciplinary huddle, earlier preparation of the electronic health record for discharges, and prioritizing rounding on discharge-ready patients. The outcome measure was the monthly percentage of DOBN. Balancing measures were 7-day readmission rates and average length of stay (LOS). The primary measure was analyzed using a statistical process control chart (p-chart), and the balancing measures were analyzed using run charts.</p><p><strong>Results: </strong>The baseline rate of DOBN on the PHM service was 27%. After interventions, this increased to 32%. The LOS was 2.5 days, and the average 7-day readmission rate was 2.4%. Run chart analysis showed no special cause variation in the balancing measures. These results were sustained for 16 months without increasing LOS or 7-day readmission rates.</p><p><strong>Conclusions: </strong>The QI team successfully increased the DOBN rate for a PHM service by applying QI methods and adopting a multidisciplinary approach to discharge planning and preparation.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e910"},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027224","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":"Standard Elements in Studies of Adverse Events and Medical Error: the SESAME statement.","authors":"Richard T Griffey, David C Stockwell, Lee M Adler, Rachel Ancona, David Classen, Ryan M Schneider, Anne Ws Rutjes, Christopher R Carpenter, Maria Unbeck","doi":"10.1097/pq9.0000000000000931","DOIUrl":"10.1097/pq9.0000000000000931","url":null,"abstract":"<p><p>Variability and persistent gaps in reporting have been consistently observed across studies evaluating adverse events in healthcare, dating back to the early days of the patient safety movement. Incomplete descriptions-particularly missing details regarding study design, conduct, methodologies and applied definitions-impede interpretation, hinder critical appraisal and limit reproducibility. These deficiencies not only obstruct a shared understanding of findings but also diminish the overall impact such studies may have on patient safety initiatives and policy development. To address these challenges and enhance the quality of reporting, we developed the SESAME (Standard Elements in Studies of Adverse Events and Medical Error) reporting guideline. SESAME is a 44-item checklist designed to support comprehensive and standardised reporting in studies evaluating potential patient harm. The guideline was developed over a 2-year period by an international, multidisciplinary panel through a consensus-driven process aligned with EQUATOR (Enhancing the QUAlity and Transparency Of Health Research Network) standards.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e931"},"PeriodicalIF":1.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026824","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":"Standard Elements in Studies of Adverse Events and Medical Error (SESAME): explanation and elaboration.","authors":"Richard T Griffey, Lee M Adler, David C Stockwell, Peter D Hibbert, Dorthe O Klein, Rene Schwendimann, Andrew D Auerbach, Rachel Ancona, Ryan M Schneider, David Classen, Christopher R Carpenter, Anne W S Rutjes, Maria Unbeck","doi":"10.1097/pq9.0000000000000930","DOIUrl":"10.1097/pq9.0000000000000930","url":null,"abstract":"<p><p>Studies that evaluate adverse events and medical error often suffer from incomplete and inadequate reporting, which affects the interpretability and reproducibility of their findings. To address this, we developed the 44-item Standard Elements in Studies of Adverse Event or Medical Error (SESAME) checklist using a rigorous process following the recommendations of the Enhancing the QUAlity and Transparency Of health Research Network. The aim of this manuscript is to explain the scope and aim of the checklist by providing a detailed explanation of each item in the SESAME checklist, illustrated by examples from selected studies of adverse events and medical error.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e930"},"PeriodicalIF":1.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026878","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":"Quality Improvement Partnership to Improve Human Papillomavirus Vaccine Rates: Start at Age 9 Campaign.","authors":"Lauren E Ng, Jessica P Fenton, Linda Mermelstein, Lori Ellis, Randi Trope","doi":"10.1097/pq9.0000000000000927","DOIUrl":"10.1097/pq9.0000000000000927","url":null,"abstract":"<p><strong>Introduction: </strong>Human papillomavirus (HPV) infections and HPV-related cancers are preventable with vaccination. Initiating the HPV vaccine series at ages 9-10 years is associated with improved vaccination uptake and series completion. This quality improvement (QI) initiative aimed to increase first-dose HPV vaccination rates among 9- to 10-year-olds through the implementation of evidence-based interventions.</p><p><strong>Methods: </strong>Data were collected from electronic health records (EHRs) of established patients aged 9-10 years with at least 1 documented well-child visit annually from 2021 to 2024. Baseline data were obtained from January 2021 through May 2022. Interventions included provider education, adoption of a system-wide \"Start at 9\" policy, patient-facing educational materials, and EHR modifications to integrate HPV vaccine orders for patients aged 9 years and older. Monthly vaccination trends were evaluated using a P-chart.</p><p><strong>Results: </strong>A total of 9315 patients aged 9-10 years were included. The percentage of eligible patients receiving their first HPV vaccine increased from a baseline of 2% to 14% following the adoption of the \"Start at 9\" policy in conjunction with targeted educational interventions and EHR integration. A P-chart demonstrating special cause variation aligned with 2 QI interventions, indicating a sustained process shift. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination rates, used as balancing measures, remained stable throughout the study period.</p><p><strong>Conclusions: </strong>A coordinated, systems-level QI approach was associated with significant gains in early HPV vaccine initiation, supporting initiation of vaccination at age 9 years as an effective strategy to promote timely vaccination and strengthen preventive health outcomes.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e927"},"PeriodicalIF":1.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914718","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":"Report Cards as a Sustainability Tool for Guideline Adherence in Pediatric Traumatic Brain Injury.","authors":"Kaitlyn T Marks, Carlie Myers, Nathan Gregor, Shixuan Wang, Bin Zhang, Danielle K Maue, Jesse Skoch, Emily Rheaume, Meera Kotagal, Jennifer Kaplan, Maya Dewan","doi":"10.1097/pq9.0000000000000916","DOIUrl":"10.1097/pq9.0000000000000916","url":null,"abstract":"<p><strong>Introduction: </strong>Severe traumatic brain injury (TBI) is a major cause of pediatric morbidity and mortality; yet, adherence to national guidelines remains variable.</p><p><strong>Methods: </strong>We conducted a single-center quality improvement initiative in our 48-bed pediatric intensive care unit at a level 1 trauma center. Interventions included adding a TBI order set to the electronic health record and a structured \"report card\" audit-and-feedback system to monitor compliance with specified metrics in the first 72 hours of admission. The primary outcome measure was the number of severe TBI encounters with 50% or greater adherence to institutional guidelines. Process measures included the use of the order set and timeliness of report card dissemination. Key clinical metrics were also tracked. Analyses involved run charts, descriptive statistics, and nonparametric tests.</p><p><strong>Results: </strong>Of 72 children with severe TBI admitted, 60 were eligible for full guideline adherence assessment. Order set adoption increased from 13% to 92% following the implementation of the report cards and remained above 89% annually thereafter. Guideline adherence increased from 21% to 38.9% postreport cards and stabilized between 42.9% and 59.8% thereafter. Adherence was highest for temperature management, seizure prophylaxis, and cerebral perfusion pressure, whereas sodium and carbon dioxide targets remained challenging. Mortality did not differ by adherence. Higher adherence correlated with longer pediatric intensive care unit, hospital, and rehabilitation stays.</p><p><strong>Conclusions: </strong>Decision support tools and audit and feedback improved adherence to severe pediatric TBI guidelines. Future multicenter studies should assess how adherence affects functional recovery.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e916"},"PeriodicalIF":1.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914172","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":"Reducing Inpatient Pediatric Central Line-associated Bloodstream Infections by Proactive Risk Assessment and Escalation.","authors":"Chris I Wong, Claudia Hoyen, Joyce Deptola, Theresa Smith, Josephine Rey, Charles G Macias","doi":"10.1097/pq9.0000000000000928","DOIUrl":"10.1097/pq9.0000000000000928","url":null,"abstract":"<p><strong>Introduction: </strong>Central line-associated bloodstream infections (CLABSIs), despite the application of best practices, are still prevalent and cause significant morbidity and mortality in pediatric patients. We describe a quality improvement project with an aim to reduce inpatient CLABSIs focused on standardization and proactive risk assessment.</p><p><strong>Methods: </strong>The aim was to reduce inpatient CLABSI rates by 30% within 3 years beginning in January 2021. An apparent cause analysis in 2018 suggested that the lack of escalation of concerns was a potential focus area. We used Plan-Do-Study-Act cycles starting with a pilot in 2019 to roll out a CLABSI Watcher Program. After a CLABSI prevention summit in 2020, a reorganization of drivers reidentified the need for a standardized escalation process for central line (CL) concerns. A CL nurse program was then scaled across the hospital, focusing on timely proactive huddling. Hospital-wide standardization of practices occurred from 2021 to 2023. We used statistical process control charts to assess changes in CLABSI rates.</p><p><strong>Results: </strong>Special cause variation, with a downward shift in the CLABSI rate process mean compared with baseline (0.97 per 1,000 CL days), was observed starting June 2021 (0.13 per 1,000 CL days). A second shift occurred from August 2023 through December 2024 (0.00 per 1,000 CL days). The CLABSI rate decreased by 65% (0.34 per 1,000 CL days) through December 2023.</p><p><strong>Conclusions: </strong>Significant reductions in hospital CLABSI rates can be achieved by using additional measures beyond focusing on CL maintenance and insertion bundles, and particularly through developing proactive risk assessment and escalation processes.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e928"},"PeriodicalIF":1.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914741","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":"Nasal Intermittent Positive Pressure Ventilation: Guideline Implementation Guided by Practice Preference Measurement.","authors":"Sofia Gnecco-González, Emily Whitesel, John Zupancic, Munish Gupta, Dewayne M Pursley, Helen Healy","doi":"10.1097/pq9.0000000000000911","DOIUrl":"10.1097/pq9.0000000000000911","url":null,"abstract":"<p><strong>Introduction: </strong>Extremely preterm infants face a high risk of bronchopulmonary dysplasia from prolonged mechanical ventilation. Early extubation to noninvasive respiratory support may reduce lung injury. Evidence suggests that nasal intermittent positive pressure ventilation (nasal IPPV) lowers reintubation compared with continuous positive airway pressure. Understanding neonatal intensive care unit providers' practice preference, an aspect of unit culture, can facilitate adoption of practice change. This quality improvement initiative aimed to reduce rates of reintubation within 7 and 10 days of first extubation among intubated infants born before 28 weeks' gestational age within 1 year of implementing the practice change and to assess changes in unit culture following guideline implementation.</p><p><strong>Methods: </strong>A guideline recommending extubation to nasal IPPV for infants born before 28 weeks' gestational age and/or 1250 g or less at birth was developed following measurement of staff practice preferences using the Neonatology Survey of Interdisciplinary Groups in Healthcare (NSIGHT) and internal data review, implemented in a level III neonatal intensive care unit in 2023. Data from January 2020-September 2025 were analyzed using statistical process control charts. The validated NSIGHT was repeated in August 2025 and compared with preimplementation results.</p><p><strong>Results: </strong>Over 5.5 years, 200 eligible infants were extubated. Reintubation rates within 7 days changed (from 39% in 2020 to 13% in 2025; <i>P</i> = 0.058). Rare-events analysis demonstrated special cause variation in 2025, with an increasing number of extubations between reintubation events. A significant shift was detected in the extubation rate to nasal IPPV from 32% to 83%. The 2025 NSIGHT results showed a net unit preference for nasal IPPV after extubation (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>A practice guideline, informed by NSIGHT results and internal data, was implemented to promote extubation of extremely preterm infants to nasal IPPV. Changes were achieved in clinical practice, reintubation rates, and unit culture.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e911"},"PeriodicalIF":1.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914729","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":"Achieving Faster Bleeding Disorder Treatment in the Emergency Department: A Quality Improvement Initiative.","authors":"Kristen Adams, Megan Caskey, Lindsey Neill, Daryl Moczygemba, Yingchao Yuan, Sheryl Yanger, Erin Munns, Jennifer Heineman, Arun Gurunathan","doi":"10.1097/pq9.0000000000000905","DOIUrl":"10.1097/pq9.0000000000000905","url":null,"abstract":"<p><strong>Introduction: </strong>People with bleeding disorders (PwBD) often rely on the emergency department (ED) for clotting factor concentrate (CFC) administration for apparent or suspected bleeding. Timely CFC administration reduces complications but is challenging due to high ED patient volumes and uncertainty about the treatment type, dose, and timing (especially in the pediatric population). Our project aimed to improve the time to CFC for PwBD presenting to the ED with bleeding concerns, with an initial SMART (specific, measurable, achievable, relevant, and time-bound) aim of decreasing the median time from 129 to 99 minutes within 6 months.</p><p><strong>Methods: </strong>Our interventions included educational initiatives, personalized management cards, improved hematology-to-ED communication, and the development of an evidence-based algorithm and guideline.</p><p><strong>Results: </strong>We exceeded our SMART aim, reducing the median time to CFC to82 minutes during the 6 months, and since then we have further improved treatment times, with a median time to CFC of 61 minutes since project initiation (53% reduction from baseline) and a median time to CFC of 41 minutes during the most recent 6 months of data collection (68% reduction from baseline).</p><p><strong>Conclusions: </strong>Our results highlight the successful and sustained application of quality improvement methodologies to improve CFC administration time in PwBD.</p>","PeriodicalId":74412,"journal":{"name":"Pediatric quality & safety","volume":"11 5","pages":"e905"},"PeriodicalIF":1.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898306","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}