A multicenter collaborative approach to reducing pediatric codes outside the ICU.

Area of Science:

• Pediatric patient safety
• Healthcare quality improvement
• Multicenter collaboration

Background:

• Pediatric codes outside the intensive care unit (ICU) represent critical safety events.
• The Child Health Corporation of America initiated a collaborative to address these events.
• Improving patient safety culture is crucial for preventing adverse events.

Purpose of the Study:

• To decrease the rate of pediatric codes outside the ICU by 50%.
• To double the interval between these critical events.
• To improve patient safety culture scores by 5 percentage points.

Main Methods:

• A multidisciplinary panel developed a change package with process improvement strategies.
• Twenty hospitals participated in a 12-month collaborative improvement project.
• Hospitals implemented strategies using rapid-cycle methodologies to improve prevention, detection, and correction of patient deterioration.

Main Results:

• The overall code rate did not significantly decrease during the collaborative (3% reduction).
• Twelve hospitals showed significant improvement in code rates (24% reduction) after the collaborative period.
• Patient safety culture scores improved by 4.5% to 8.5%.

Conclusions:

• Achieving significant outcomes in complex processes like patient deterioration requires sustained effort.
• A collaborative model can accelerate quality improvements within individual healthcare institutions.
• Embedding a culture of patient safety is essential for long-term success.