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What we are doing to keep your child safe

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Akron Children's Hospital embraces the Institute of Medicine's (IOM) definition of healthcare quality as a way to measure and improve our patient safety and quality.  According to the IOM, medical care should be safe, timely, effective, efficient, equitable and family-centered.

We will show how our quality outcomes compare to other children's hospitals in cases where we have benchmark data. This means that we all collect data in the same way and we share our data with one another. We also agree on what constitutes best practice.

In other cases, there is no agreement on what constitutes best practice nor is there sharing of quality data. Instead, we have established our own standards and goals.

Since the diseases that affect children are quite different from those of adults, it is often not appropriate to use adult measures to evaluate the quality of pediatric care. However, through our collaborations with other children's hospitals, we are working to develop additional evidence-based measures for patient quality in children and teens.

A number of our quality initiatives focus on reducing medical errors, promoting hand hygiene, and ensuring that we use the least amount of radiation in imaging studies and procedures.

Adverse Drug Events

Administering medications to children brings special challenges to providing safe doses because, unlike adult drugs, a child’s dose is based on his/her weight.

From the ordering to the delivery of the drug, we have several checks in place to make sure that our processes provide correct and safe doses to our patients. We pay particular attention to Adverse Drug Events.

What are we doing to improve

Akron Children’s Hospital is involved in a number of national quality improvement efforts with other children’s hospitals, including the Ohio Children’s Hospitals' Solutions for Patient Safety. With the 7 other children’s hospitals in the state, we share our data and learn from one another’s events so that best medication safety practices can be identified and implemented. Adverse drug events in Ohio have dropped by more than 34%. The overall goal of the collaborative work is to eliminate all harm to the children in Ohio hospitals.

We also continually monitor the use of medications and look for data trends that may bring concern. When an issue is identified, we take proactive steps to prevent risk of harm. We expect nothing less for your children or our own.

Central Line-Associated Bloodstream Infections

A central line is a tube that goes into a large vein of a patient's body – usually chest or neck – to quickly deliver blood, fluid or medication to a patient. If the central line or area around it gets dirty, germs can enter the patient's bloodstream and cause infection.The reduction of central line-associated bloodstream infections is a primary goal of Akron Children's Hospital. 

Central line bloodstream infections can make patients very sick, and lead to significant medical costs. 

As part of our infection control program, we routinely track the number of central line-associated bloodstream infections that occur in our critical care units.

What we measure and why

Newly born infants in general, and premature infants in particular, are at a higher risk for bloodstream infections because of immature immune systems, poor skin integrity, repeated invasive procedures, and exposure to numerous caregivers. It’s estimated that each neonatal bloodstream infection costs about $35,000 and adds about 2 weeks to a baby’s hospital stay.

How do we measure?

We benchmark our central line infection rates using the CDC National Healthcare Safety Network rates. The infection rate is the number of infections per 1,000 days the patient received central line treatment. Our goal is to have zero central line-associated infections.

Radiation Management

Akron Children's Hospital strongly supports the national Image Gently campaign to reduce radiation exposure in children. Our radiology staff uses specialized pediatric protocols that limit the amount of exposure children receive.

What do we measure?

We measure the radiation doses produced by all of our imaging machines. We give special attention to the machines with the capacity to produce higher doses and actively monitor the doses given during specific exams that have the potential to produce higher doses, such as CT scans.

How do we measure?

A licensed radiation physicist checks all of our machines, and the machines that have the potential to produce a higher radiation dose have built-in dose measuring software.

What are we doing to improve?

We are currently participating in two national dose reduction programs. The first is Image Gently, which aims to:

  • Increase awareness to lower CT radiation dose while maintaining image quality
  • When appropriate, use an alternative imaging strategy that does not use ionizing radiation
  • Determine if the ordered CT scan is justified by the clinical indication
  • Establish baseline radiation doses for pediatric patients by "child-sizing" CT scanning parameters
  • Optimize pediatric examination parameters (ALARA)
  • Scan only the indicated area: Scan once
  • Prepare a child-friendly and expeditious CT environment

The second initiative is known as Featherlight Imaging. This program includes a set of guidelines produced by GE that are applied to our CT machines to reduce pediatric doses.

In addition, radiology leadership at Akron Children's has instituted stricter guidelines that prevent unnecessary scanning of children, and which incorporate the substitution of MRI and ultrasound (both of which are radiation-free) for CT imaging, when appropriate.

Our radiology department has also completed multiple lean six sigma projects to reduce doses on an issue-by-issue basis, such as image coning, repeat image reduction, and more. Image coning focuses the radiation only on the area or body part that needs X-rayed.

Eliminating radiation in heart procedures

At Akron Children's, our cardiologists in our arrhythmia center use alternative techniques and technologies to virtually eliminate the use of fluoroscopy during cardiac ablations, reducing young patients' lifelong risk of cumulative radiation exposure.

 

Hand Hygiene

Preventing the spread of infection is a basic part of patient safety. The most important and effective way to prevent the spread of infection is to ensure our staff cleans their hands before and after every patient encounter. We provide alcohol-based hand sanitizer throughout the hospital for this purpose.

It's also important that you and your family practice good hand hygiene to prevent the spread of infection.

How do we measure?

To measure our hand hygiene rate, we use "hand hygiene coaches" to observe and record how we are doing. We also welcome input from our patients, visitors and caregivers about our hand hygiene practices. Don't be afraid to speak up and ask questions, or to remind us to wash our hands when we are giving care to your child.

The Institute of Medicine (IOM) defines timely care as reducing wait times and sometimes harmful delays. For us, this means reducing our ER wait times and immunizing children according to the American Academy of Pediatrics' recommendations.

Determining the effectiveness of medical care is two-fold. First, we measure the accuracy or success of a diagnosis and treatment when carried out in an average clinical environment. Second, we evaluate the extent to which a treatment achieves its intended purpose.

Immunization Rate

Akron Children's Hospital Pediatrics, our network of pediatrician offices, aims to ensure our patients are fully immunized by 2 to 3 years of age with primary immunizations. 

Even though most infants and toddlers have received all of the recommended vaccines by age 2, many children are under-immunized, leaving the potential for outbreaks of disease.

What we measure and why

We measure the primary immunization rates for children ages 3 years and younger, comparing the rates of our pediatric primary care network, Akron Chidlren's Hospital Pediatrics (ACHP), with the state and national average.

The Institute of Medicine (IOM) defines efficiency as avoiding waste, including waste of equipment, supplies, ideas and energy. By being efficient, we avoid contributing to the high cost of healthcare in the U.S.

One example of an efficiency measure is making sure that a child stays in the hospital for the right length of time, but no longer than necessary. Another example includes making sure that a child does not have to be readmitted to the hospital within a short period of time, which indicates that the child may have been discharged too soon.

Length of Stay and Readmission Rates

Children need to stay in the hospital for the right amount of time during their admission – long enough to treat their condition but not longer than necessary. Finding this balance is done on a patient by patient basis, and then we compare our results to other children’s hospitals around the state of Ohio.

We also examine our readmission rate, which is how often a child needs to be readmitted to the hospital within 72 hours of being discharged.

One of Akron Children's missions is to provide medical care to infants, children and teens, regardless of their ability to pay.  

We also strive to improve access to care for children throughout northeast Ohio. We do this by providing a number of services at various locations through the region, including our primary care offices, ERs, and outpatient specialty offices.

We also measure the days to the next available appointment.

At Akron Children's Hospital, we embrace a culture of family-centered care, an approach to patient care that is respectful and responsive to individual parent and family preferences, needs and values.

We have several ways that we ensure the care we provide is family-centered, including a Parent Advisory Council and family-centered care committee.

Family-centered care shapes our policies, programs, facility design, and day-to-day interactions with our patient families. We recognize the important role families play in ensuring the health and well-being of children. We also understand that emotional, social and developmental support are integral components of healthcare.

We respect the strengths of each patient family and seek to build on these strengths and support families in their caregiving and decision-making roles. Family-centered approaches lead to better health outcomes and better allocation of resources as well as greater patient and family satisfaction.