akronchildrens.org

Ohio’s children’s hospitals share solutions for safety

The whole nation is looking to Ohio when it comes to keeping kids safe when they need to be hospitalized.

Akron Children’s Hospital and the seven other pediatric hospitals in the state have teamed up to improve the quality of care and reduce adverse safety events. Their collaboration since 2009 has resulted in a:

  • 60 percent reduction in surgical site infections in cardiac, neurosurgery and orthopedic procedures.
  • 40 percent reduction in overall adverse drug events.

These efforts have saved more than 7,700 children from unnecessary harm and have avoided $11.8 million in unnecessary healthcare costs, such as the added days children have to stay in the hospital if they develop a surgical site infection.

In January 2009, Ohio Children’s Hospitals’ Solutions for Patient Safety was formed with the help of a grant from the Cardinal Health Foundation. In December 2011, the organization was awarded a multi-million dollar contract with the U.S. Department of Health and Human Services to spread its safety efforts nationwide. It is the only contract focusing on pediatric efforts and reducing Medicaid costs.

“Ohio’s children’s hospitals’ first experience in collaborating on patient safety efforts happened in 2006 when we worked together to establish rapid response teams,” said Mike Bird, MD, vice president for medical services and patient safety officer at Akron Children’s. “These teams are now available to respond immediately any time, day or night, a patient’s condition is deteriorating and rapid assessment and treatment are needed. A level of trust was established among the institutions during that project and we decided we’re not going to compete on patient safety issues. We’re going to do what’s right for kids.”

On March 15, chief executive officers, board members and senior administrative and medical staff leaders from 25 leading children’s hospitals around the country gathered in Columbus to learn from the Ohio experience.

Clinical teams from the Ohio children’s hospitals will continue to work with these hospitals and then, in 2013, another 50 hospitals will be added to the collaborative.

So what were the solutions to reducing errors?

Clinical teams from the eight hospitals met every three months to discuss best practices, research and ways to standardize care.

According to Debbie Hawk, an OR nurse on the committee investigating surgical site infections, their goal was to adopt “care bundles” that would be consistent among all the surgeons and their teams.

These included giving patients a preventative antibiotic within an hour before the incision, using a recommended surgical prep solution and removing hair with surgical clippers instead of razors to reduce skin irritation.

Since adopting these procedures, Akron Children’s has reduced surgical site infections for cardiac, spinal and neurological surgeries from 14 in 2009 to two last year.

In addition, every hospital employee, from janitors to the CEO, participated in a three-hour error prevention training session. The training addressed topics such as how employees should speak up if they notice a colleague doing something that could cause harm to a patient.

“We encourage a questioning environment and hope to break down hierarchies in health care,” said Dr. Bird. “No one should be afraid to speak up.”