Identifying Hospitals With High Performance in Pediatric Safety for All Children | JoVE Visualize

Area of Science:

Healthcare Quality Improvement
Patient Safety Research
Health Equity Studies

Background:

Adverse safety events significantly contribute to patient morbidity and mortality.
The Agency for Healthcare Research and Quality (AHRQ) developed seven pediatric-specific quality indicators (PDIs) to assess severe, preventable adverse outcomes.
Previous research indicated disproportionate impacts of PDI safety events on Black and Hispanic pediatric patients, with significant inter-hospital variation.

Purpose of the Study:

To adapt Centers for Medicare and Medicaid Services (CMS) methods for identifying hospitals that demonstrate excellence in pediatric safety equity.
To define pediatric safety equity as achieving both high overall patient safety and minimal racial/ethnic disparities.
To lay the groundwork for future investigations into best practices at high-performing hospitals for advancing pediatric safety equity.

Main Methods:

Utilized positive deviance methods, which focus on studying high-performing entities to uncover successful strategies.
Adapted methodologies previously employed by the Centers for Medicare and Medicaid Services (CMS).
Focused on identifying hospitals that excel in both overall pediatric safety and the reduction of disparities in safety events.

Main Results:

The study successfully adapted CMS methods to identify hospitals excelling in pediatric safety equity.
Established a framework for defining and measuring pediatric safety equity, combining overall safety performance with disparity reduction.
Highlighted the potential for positive deviance approaches in understanding and addressing health disparities in pediatric care.

Conclusions:

Pediatric safety equity can be defined and measured by assessing both high overall safety and low disparities.
Identifying and studying high-performing hospitals offers a promising avenue for discovering interventions to improve pediatric patient safety broadly.
Future research should focus on exploring the specific practices of these high-performing hospitals to advance health equity in pediatric safety.