What Indicators help in judging quality for our pediatric patients?

We use several indicators.  Here are some of them:

• National PICU Measures

Rockford Memorial Hospital participates in a voluntary national pediatric critical care data base developed by pediatric critical care physicians called “VPS”.  VPS is a partnership between Children’s Hospital Los Angeles, the National Association of Children’s Hospitals and Related Institutions (NACHRI) and the National Outcomes Center.  The 47 participating hospitals submit data to VPS so they can compare their performance against the group as a whole (called the “VPS reference group” in the charts below) and use the results for continuous quality improvement.

The most recent data available from VPS covers calendar year 2008.  Here are some examples of our results.  Click on the links below for more information on each topic.

Effective Care:  Unscheduled PICU Readmission with 24 Hours

Effective Care: Unscheduled Admission to PICU

Efficient Care: Average PICU Length of Stay

Efficient Care: PICU Discharges Delayed 4 Hours or More

Effective Care: PICU Adjusted Mortality Ratio

Preventing Hospital-Acquired Infections in the PICU

Ventilator-Associated Pneumonia (VAP)

Ventilator-associated pneumonia is a serious infection of the lungs that can be caused when germs (bacteria) enter the lungs through ventilator equipment required to help very ill children breath.  VAP is considered a serious complication that can can make a child much sicker and prolong recovery.

Limiting ventilator use, proper hand-washing, thorough cleaning of equipment, providing frequent, good mouth hygiene and isolating patients known to have contagious germs can all help prevent VAP.

Rockford Memorial Hospital has had ZERO VAPs in its Pediatric Intensive Care Unit since 2006, and ZERO VAPs in its Neonatal Intensive Care Unit since fourth quarter 2008.

Central Venous Catheter Associated Blood Stream Infections

Patients become very ill if germs enter the bloodstream through the use of a central line catheter.  A central line catheter is a small plastic tube placed into the blood vessels near the heart to deliver medication or nutrition, or to draw blood tests or monitor blood pressure. 

Due to meticulous care in the use of central lines, the PICU at Rockford Memorial Hospital has had ZERO central line blood stream infections since 2007.

• Chronic Disease Management in Inpatient and Outpatient Areas

Asthma Measures

Effective management of chronic illnesses is another indication of quality care for children.  Across the United States, the most frequent chronic condition requiring management in children is asthma.  Rockford Memorial Hospital measures the following indicators that evidence based “best practices” are being followed to manage asthma and help prevent the need for repeated hospitalization.

Reliever Medication

The National Asthma Education and Prevention Program and the American Academy of Pediatrics have recommended the use of asthma relief medications to gain control of an asthma attack as quickly as possible.  Relievers relax the muscles around the wind pipe.

Throughout 2009, every monthly measurement of the treatment of children with asthma at Rockford Memorial Hospital has shown that 100% are receiving the recommended asthma reliever medication.  (If you want, you can create a chart showing percent of children with asthma who receive reliever medication in the hospital, with 100% for every month – or use some other visual to make this point)

Corticosteroid Medication

The National Asthma Education and Prevention Program and the American Academy of Pediatrics have recommended the use of corticosteroid medication to manage asthma in children.  Corticosteroids are medications that reverse the narrowing of the windpipes caused by asthma.  Scientific studies have proven the importance of every child with asthma receiving this treatment.  Measuring the number of children who receive this important treatment is one indication of how well a hospital is caring for pediatric asthma patients.

Throughout 2009, Rockford Memorial Hospital has achieved 100% in providing this important treatment to children with asthma.  (Create a visual if you like)

Discharge Plan

Repeated hospitalizations can be avoided when children are sent home with a thorough and complete post-hospital care plan.  We have begun measuring the completeness of every child’s discharge plan for six important elements.  Improvement teams are actively working to create processes supported by our new electronic medical record to assure this occurs for every child and to improve our performance, which is currently 25 percent.