scholarly journals Improving ECG Services at a Children’s Hospital: Implementation of a Digital ECG System

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Frank A. Osei ◽  
Gregory J. Gates ◽  
Steven J. Choi ◽  
Daphne T. Hsu ◽  
Robert H. Pass ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Outpatient Service ◽  
Digital System ◽  
Quality Improvement Initiative ◽  
Fourfold Increase ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean ◽  
Significant Change

Background.The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children’s hospital.Methods.As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children’s Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared viat-tests.Results.The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p<0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p<0.001).Conclusion.Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported.

scholarly journals Reduction in Inpatient Central Line Associated Blood Stream Infection Post Implementation of Bundled Care Measures in Patients with Benign and Malignant Hematological Conditions in a Single Pediatric Institution

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4463-4463
Author(s):  
Anupam Verma ◽  
Lauri Linder ◽  
Elizabeth D Knackstedt ◽  
Cheryl Gerdy ◽  
Rouett Abouzelof ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Central Line ◽  
Care Quality ◽  
Quality Improvement Initiative ◽  
Intervention Period ◽  
Post Intervention ◽  
Oncology Patients ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Viridans Group Streptococci

Abstract Background: Central line associated blood stream infections (CLABSIs) are a significant source of morbidity, mortality and cost for pediatric hematology/oncology patients. In response to increasing CLABSI rates, the Hematology/Oncology division at Primary Children's Hospital (PCH) initiated a quality improvement project to reduce CLABSIs in January 2011. This effort included participation in the Children's Hospital Association (CHA) quality improvement initiative targeted at reducing CLABSIs in hematology/oncology patients from 2011 through 2015, implementation of best practice central line maintenance bundles, and ongoing monitoring of staff adherence to the maintenance care bundles. Objective: The objective of this study was to study the relationship and impact of implementation of a comprehensive central line care quality improvement program on CLABSI rates and bloodstream pathogens in children admitted to our hospital with benign and malignant hematological conditions. Methods: We retrospectively identified CLABSIs in children with a hematology/oncology diagnosis admitted to the 32 bed immunocompromised unit at Primary Children's Hospital from January 2006 through July 2015. We used the National Health Safety Network and Center for Disease Control's definition for CLABSI. The pre-intervention period was from January 2006 through December 2010. The post-intervention period was from January 2011 through July 2015. We calculated CLABSI events per 1000 line days for both the pre- and post-intervention groups. In January 2011, our hospital implemented a central line quality improvement initiative, which includedCDC-based guidelines on: daily central line assessment, hand hygiene, sterile/non-sterile gloves and mask depending on procedure, specific central line site care protocols with scrub and dressing change schedule, specific hub/cap/tubing care and parental fluid/medication administration. Results: More than 75% of CLABSIs in hospitalized children with a hematology/oncology diagnosis, in both the pre- and post-intervention periods occurred in patients with benign and malignant hematological conditions. From 2006-2010, there were 156 infections [4.84/1,000 line days (32,229 line days)] documented in hospitalized hematology/oncology patients of which 123 infections were in patients with any hematological condition. This decreased to 80 infections [2.86/1,000 line days (28,003 line days)] in all hospitalized hematology/oncology patients, and to 65 in patients with any hematological conditions from 2010-2015 (Fig 1). Viridans group Streptococci was the leading cause of CLABSIs in both pre- and post-intervention periods (27% and 20%, respectively), but we observed post-intervention notable decreases among Viridans group Streptococci, coagulase-negative Staphylococci, and Candida species. Gram negative and Enterococcus spp. infections appeared to remain similar in the pre- and post-intervention period (Fig 2). Conclusion: In both pre- and post-implementation periods, patients with benign and malignant hematological conditions comprise the majority (75%) of all hematology/oncology patients who experience CLABSI events.After implementation of a central line care quality improvement initiative in 2011, CLABSI events decreased among all hematology/oncology patients, with apparent decreases noted in infections involving Viridans group Streptococci, coagulase-negative Staphylococci and Candida spp. It appears as though CLABSIs due to organisms common to the lower gastrointestinal tract, i.e. gram negative organisms and Enterococcus spp., were similar in both study periods. This may indicate that infections involving these organisms may be less amenable to reduction with current best practice central line maintenance care bundles. Continuing to evaluate these data will not only further our understanding of CLABSIs in patients with benign and malignant hematological conditions but also bloodstream infections (BSI) in general in the hematology/oncology population. This information will guide ongoing refinements of interventions to reduce BSI in this population. Figure 1. CLABSI events and annual CLABSI rate 2006-2015 Figure 1. CLABSI events and annual CLABSI rate 2006-2015 Figure 2. Causative pathogens in CLABSI events among patients with benign and malignant hematological conditions pre- and post-intervention Figure 2. Causative pathogens in CLABSI events among patients with benign and malignant hematological conditions pre- and post-intervention Disclosures No relevant conflicts of interest to declare.

Parent Pagers: Improving Patient Experience and Efficiency in Paediatric PACU

2017 ◽  
Vol 27 (5) ◽  
pp. 110-116
Author(s):  
G Byrn
Keyword(s):  
Quality Improvement ◽  
Patient Experience ◽  
Quality Improvement Initiative ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Improve Patient

A quality improvement initiative undertaken by the paediatric recovery team at the Leeds Children's Hospital sought to improve patient experience and efficiency by implementing an electronic pager system to contact parents/carers following their child's surgery.

scholarly journals A Quality Improvement Initiative: Reducing Blood Culture Contamination in a Children’s Hospital

PEDIATRICS ◽  
2018 ◽  
Vol 142 (4) ◽  
pp. e20180244 ◽  
Author(s):  
Rana E. El Feghaly ◽  
Jahnavi Chatterjee ◽  
Kristin Dowdy ◽  
Lisa M. Stempak ◽  
Stephanie Morgan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Blood Culture ◽  
Quality Improvement Initiative ◽  
Children's Hospital ◽  
Children’S Hospital

scholarly journals Expansion of a multi-pronged safe sleep quality improvement initiative to three children’s hospital campuses

2020 ◽  
Vol 7 (S1) ◽  
Author(s):  
Traci Leong ◽  
Kerryn Roome ◽  
Terri Miller ◽  
Olivia Gorbatkin ◽  
Lori Singleton ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Sleep Quality ◽  
Quality Improvement Initiative ◽  
Safe Sleep ◽  
Children's Hospital ◽  
Children’S Hospital

scholarly journals The Utility of Interaction Design as a Novel Tool to Improve Hand Hygiene Frequency on a Pediatric Hematology-Oncology Ward

2020 ◽  
Vol 41 (S1) ◽  
pp. s411-s411
Author(s):  
Johanna Blaak ◽  
Rachel DiMaio ◽  
Julia Kupis ◽  
Ross Sweetzir ◽  
Conny Betuzzi ◽  
...  
Keyword(s):  
Health Services ◽  
Hand Hygiene ◽  
Interaction Design ◽  
Qualitative Interviews ◽  
Cell Transplant ◽  
Children's Hospital ◽  
University Of Calgary ◽  
Children’S Hospital ◽  
The Mean ◽  
Alberta Health

Johanna Blaak, W21C, University of Calgary; Rachel DiMaio, University of Calgary; Julia Kupis, University of Calgary; Ross Sweetzir, Cisco Systems; Conny Betuzzi, Alberta Children’s Hospital, Alberta Health Services; Corey Dowler, Alberta Children’s Hospital, Alberta Health Services; Krista McIntytre, Alberta Children’s Hospital, Alberta Health Services; Jaime Kaufman, University of Calgary; Greg Hallihan, University of Calgary; John Conly, Foothills Medical Centre; Joseph Vayalumkal, Alberta Childrens HospitalBackground: Interaction design offers a novel interventional strategy to enhance hand-hygiene compliance (HHC) and reduce hospital-acquired infections (HAIs) in the pediatric setting. A quality improvement initiative in collaboration with the University of Calgary and Alberta Health Services led to the implementation of a pilot project with sensor-embedded alcohol -based hand rub (ABHR) dispensers at a hematology-oncology and hematopoietic stem cell transplant unit at Alberta Children’s Hospital (ACH). Methods: Internet of things (IoT) sensors were installed in ABHR dispensers (n = 3) on the unit. Usage data were transmitted to a local server using an MQTT messaging protocol for 16 weeks. Real-time data visualization was presented on a central display next to the nursing station with 11 unique pediatric themes including dinosaurs, transportation, and Canadian animals. Data were collected with and without visualization, and frequency of use (FoU) was determined for both periods. Qualitative interviews with unit stakeholders (n = 13) were held to determine perceptions of the intervention. Results: During the first 8 weeks of the study period, the mean daily use without visualization was 47 times (SD, 14.5) versus 99 times (SD, 23.9) with visualization. When accounting for novelty, by removing the first week of data, the mean daily use was 92 (SD 19.6). The percentage increase from period 1 to period 2 was 96.6%, accounting for novelty. Qualitative interviews with stakeholders (n = 13) on the unit indicated that the intervention increased their personal awareness of hand hygiene (75%) and acted as a constant reminder to perform hand hygiene for everyone on the unit including nonclinical staff, patients, and family members (92%). Conclusions: These limited data suggest that interaction design may improve HH frequency and show promise as a tool for increased HH awareness and education. Interaction design provides a unique, innovative, and acceptable hand hygiene improvement strategy for staff, patients, and families in the pediatric inpatient setting.Funding: NoneDisclosures: None

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