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Children's Hospitals' Solutions for Patient Safety Collaborative Impact on Hospital-Acquired Harm
Anne Lyren1, Richard J Brilli2, Karen Zieker3
1Departments of Pediatrics and Bioethics, University Hospitals Rainbow Babies & Children's Hospital, School of Medicine, Case Western Reserve University, Cleveland, Ohio; anne.lyren@uhhospitals.org.
Insights
A collaborative of 33 children's hospitals significantly reduced hospital-acquired conditions (HACs) and serious safety events (SSEs) by implementing best practices and improving safety culture. This demonstrates the effectiveness of structured collaboration in reducing patient harm.
Area of Science:
- Pediatric Patient Safety
- Healthcare Quality Improvement
- Hospital-Acquired Conditions (HACs) Reduction
Background:
- Hospital-acquired conditions (HACs) and serious safety events (SSEs) pose significant risks to pediatric patients.
- Effective strategies are needed to reduce preventable harm in children's hospitals.
- A collaborative approach can facilitate the dissemination and implementation of best practices.
Purpose of the Study:
- To evaluate the impact of a collaborative improvement initiative on HACs and SSEs in children's hospitals.
- To assess the effectiveness of implementing reliable best practices and fostering a culture of safety.
- To determine if a structured collaborative can lead to significant reductions in hospital-acquired harm.
Main Methods:
- A 3-year prospective cohort study involving 33 children's hospitals.
- Utilized a 12-month historical control population for comparison.
- Focused on identifying and disseminating best practices for 9 HACs and SSE reduction, emphasizing process and safety culture improvements.
Main Results:
- Significant harm reduction observed in 8 of 9 common HACs (9%-71% reduction).
- Mean monthly SSE rate decreased by 32% (0.77 to 0.52).
- 12-month rolling average SSE rate decreased by 50% (0.82 to 0.41).
Conclusions:
- Participation in a structured collaborative led to significant reductions in HACs and SSEs.
- Implementing best-practice prevention bundles and safety culture interventions proved effective.
- Structured collaboration and rapid sharing of evidence-based practices are key to decreasing hospital-acquired harm.
Objectives:
To determine if an improvement collaborative of 33 children's hospitals focused on reliable best practice implementation and culture of safety improvements can reduce hospital-acquired conditions (HACs) and serious safety events (SSEs).
Methods:
A 3-year prospective cohort study design with a 12-month historical control population was completed by the Children's Hospitals' Solutions for Patient Safety collaborative. Identification and dissemination of best practices related to 9 HACs and SSE reduction focused on key process and culture of safety improvements. Individual hospital improvement teams leveraged the resources of a large, structured children's hospital collaborative using electronic, virtual, and in-person interactions.
Results:
Thirty-three children's hospitals from across the United States volunteered to be part of the Children's Hospitals' Solutions for Patient Safety collaborative. Thirty-two met all the data submission eligibility requirements for the HAC improvement objective of this study, and 21 participated in the high-reliability culture work aimed at reducing SSEs. Significant harm reduction occurred in 8 of 9 common HACs (range 9%-71%; P < .005 for all). The mean monthly SSE rate decreased 32% (from 0.77 to 0.52; P < .001). The 12-month rolling average SSE rate decreased 50% (from 0.82 to 0.41; P < .001).
Conclusions:
Participation in a structured collaborative dedicated to implementing HAC-related best-practice prevention bundles and culture of safety interventions designed to increase the use of high-reliability organization practices resulted in significant HAC and SSE reductions. Structured collaboration and rapid sharing of evidence-based practices and tools are effective approaches to decreasing hospital-acquired harm.
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