PHM Quality Improvement Collaboratives An Update

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PHM Quality Improvement CollaborativesAn Update
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Collaborative 1Co Chairs Shannon Phillips,
MD, MPHPaul Hain, MD

• Specific AIM
• We will reduce the percent of patient ID band
  errors at hospitals in this collaborative by 50
  by September 1, 2010.

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Collaborative Colleagues

• Consulting
• Monroe Carell Jr. Children's Hospital at
  Vanderbilt TN
• Paul Hain, MD
• Collaborative
• Cleveland Clinic Childrens Hospital OH
• Shannon Phillips, MD, MPH
• Meredith Lahl, RN, MSN, CNS 
• Denver Childrens Hospital CO
• Dan Hyman, MD
• Mariel Laire
• New York Hospital Queens
• Laurie Gordon, MD
• Our Lady of the Lake Regional Medical Center LA
• Steve Narang, MD
• Tracie Major, APRN, CNS, CPN
• James Whitcomb Riley Childrens Hospital IN
• Michele Saysana, MD
• Scottsdale Healthcare Hospitals AZ
• John Pope, MD

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Results
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Change Concepts

• Raise awareness of safety risk for
• Staff
• Parents/Patients
• Shared educational materials
• Kinder, gentler ID bands

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Collaborative 2Co ChairsMark Shen, MDJulia
Shelburne,MD

• Specific Aim
• Over the next 6 months, we will lead a quality
  improvement collaborative and achieve measureable
  improvement in the frequency AND timeliness of
  communication of patient information to the PCPs
  at discharge with the Goal of 90 of hospitalist
  discharges at each participating hospital will
  have documentation of communication with a PCP
  within 2 calendar days of actual discharge.

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Participants

• Lora Bergert Kapiolani Medical Center, Honolulu
• Michael Bryant USC Keck School of Medicine
• David Cooperberg St. Christophers, Philadelphia
  
• Dan Coughlin Hasbro Childrens, Providence
• Leah Mallory Barbara Bush Childrens Hospital at
  Maine Medical Center ,Portland
• Beth Robbins Anne Arundel Medical Center,
  Annapolis
• Julia Shelburne UT-Houston Medical
  School/Childrens Memorial Hermann Hospital
• Mark Shen and Don Williams Dell Childrens
  Medical Center, Austin
• Ann Vanden Belt St. Joseph Mercy Hospital,
  Ypsilanti, MI
• Joyce Yang, Dan Hershey, and Erin Stucky Rady
  Childrens Hospital, San Diego

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Results
Percent of discharges with documented
communication with PCP within 2 calendar days
of discharge, by month
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Change Package

• Obtain support of hospital leadership
• Gather accurate contact information
• Automate the process using IT solutions
• Provide targeted and timely feedback to
  physicians
• Create incentives for attending physicians

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Collaborative 3Co Chairs Matt Garber,
MDBeth Robbins, MD

• Specific AIM
• Reduce the use of inhaled short-acting
  bronchodilators in children hospitalized with
  bronchiolitis
• To reduce the number of bronchiolitis patients
  treated with any bronchodilator medication by 20
  from that institutions baseline or to lt30
• To reduce the average total number of treatments
  per patient by 50 from that institutions
  baseline

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Participants

• Elizabeth L. Robbins, Anne Arundel Medical Center
• Jeanann P. Pardue MD, Director of CPG Inpatient
  Service East TN Children's Hospital
• Michele Lossius, MD, FAAP Assistant Professor,
  UF-COM
• Eric Balighian, Pediatric Hospitalist, St. Agnes
  Hospital
• John A Pope MD, MPH, Physician Director,
  Pediatric Services, Scottsdale Healthcare
  Hospitals
• Matthew Garber, MD,FAAP, FHM, Assistant Professor
  USC-SOM, Director Pediatric Hospitalists

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Bronchodilator Use Preliminary DataAverage of
25 decrease
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of Bronchodilator doses/pt Prel DataAverage
of 47 Decrease
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Change package

• A Respiratory Therapists Driven Protocol
• Communication at every level nurse, RT, PCP, ED
  attendings, other hospitalists, learners - is
  needed to address cultural barriers
• New partnerships with RT, RN, IT, CQI, and
  administration are also needed to address
  technical barriers

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Next Steps for PHM QI Collaboratives..

• We have tested the concept
• PHM Physicians Can Collaborate to Improve Care
• Next Challenge
• Sustaining and Disseminating
• Finding a home for funding and infrastructure
• MOC for Pediatric Hospitalists ?