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Children's National Health System

The Bear Institute at Children’s National Health System posts quality indicators based on real-time patient data to improve quality and safety.

What if clinicians had a tool that could warn them when a patient is in imminent danger of developing a urinary tract infection or another complication?

Researchers at the Bear Institute, a close collaboration between Cerner and Children’s National Health System, have developed such a tool, which they are using to improve outcomes.

Quality Boards are highly visible digital dashboards that display real-time quality and safety indicators based on live patient information. Clinicians at the Washington, D.C.-based health system are using this information to take a more proactive approach to patient care.

Placing quality and saftey 'front and center'
Children’s National is seeing “significant improvements in urinary catheter days, urinary tract infection rates, consent rates and medication reconciliation,” said Brian Jacobs, MD, vice president, chief medical information officer and chief information officer. “We have now placed quality and safety front and center within everyone’s workflow, allowing care teams and families to engage directly in improving outcomes.”

In a peer-reviewed study, which has been accepted for publication by The Joint Commission Journal on Quality and Patient Safety, researchers found that these Quality Boards helped clinicians in the hospital’s Pediatric Intensive Care Unit (PICU):

  • Decrease the average time from admission to treatment consent by 49 percent
  • Lower the percentage of patients with urinary catheters in place for more than 96 hours to 4 percent from 11 percent
  • Improve completion of medication reconciliation to 92 percent from 80 percent

“The statistics showed dramatic change,” said Craig Futterman, MD, a pediatric cardiac intensivist who helped develop the tool. “Things were done faster. Things were done better.”

Visible to providers and family members

Working first independently, and then with Cerner through the Bear Institute, Dr. Futterman and others used an electronic health record tool to pull patient safety compliance data from PICU patient records. The system then posts the data in real-time on two, 50-inch displays, which are visible to both providers and family members.

The display includes data on consent for treatment, restraint orders, deep venous thrombosis prophylaxis, presence of urinary catheters, Braden Q scores and medication reconciliation.

‘We completed tasks faster’
Clinicians at Children’s National have had such great success with these Quality Boards that they have implemented them in the Neonatal Intensive Care Unit and in the Cardiac ICU. Dr. Futterman says having the Quality Boards out on the unit serves as a constant, real-time reminder of safety tasks that need to be accomplished.

“We completed tasks faster once the dashboard went up,” said Dr. Futterman, who checks the Quality Board every time he walks by.

Safety huddles twice a day
Dr. Futterman and his colleagues have a “safety huddle” twice a day — once before morning rounds and once after evening rounds 9-10 p.m. The team stands in front of a Quality Board and discusses how to resolve pressing patient safety issues.

Future plans call for the organization to install Quality Boards in Hematology, Oncology, the Bone Marrow Transplant Unit, the Emergency Department and Surgery.

“We are going to try to put dashboards on every floor,” Dr. Futterman said.

View All Client Achievement Stories
Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.