Developing Evidence for New Patient Safety Bundles Through Multihospital Collaboration

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Collaborative healthcare networks

Background:

• Multihospital collaboration is common for safety improvements.
• Limited strategies exist for developing patient safety bundles with insufficient evidence-based practices.
• The Children's Hospitals' Solutions for Patient Safety (SPS) Network aims to reduce patient harm.

Purpose of the Study:

• To develop improvement bundles for patient harm reduction when preliminary evidence is limited.
• To test and refine interventions using a collaborative approach within the SPS Network.
• To identify effective strategies for creating evidence-based harm reduction bundles in resource-limited situations.

Main Methods:

• Utilized the Pioneer process, a novel collaborative approach within the SPS Network.
• Cohorts of hospitals identified and tested interventions (factors) for specific hospital-acquired harm categories.
• Employed fundamental quality improvement techniques and planned experimentation designs.
• Analyzed aggregated hospital data using statistical methods (Shewhart charts, response plots, ANCOVA) to assess factor effectiveness.
• Categorized factors based on evidence strength and clinical support for bundle inclusion.

Main Results:

• The SPS Network initiated bundle development for nine harm types, completing the process for three.
• An analytic approach involving four scenarios and clinical input guided the selection or rejection of factors.
• The methodology proved effective in identifying interventions with strong evidentiary support for final bundles.

Conclusions:

• Quality improvement methods and planned experimentation are effective in developing evidence-based harm reduction bundles.
• This approach facilitates bundle creation even when intervention data are limited.
• Multihospital collaboration is a viable strategy for advancing patient safety initiatives.