Sometimes, it can be easy to think of children as little adults, especially when it comes to a clinical setting – but they think, act and heal differently. They require specialized care that spans the critical foundational period of their lives.
The treatment of pediatric illness and trauma is critical to the psychosocial and developmental needs of our future generations. Here are four stories demonstrating how customized health IT solutions can meet the unique requirements of pediatric care.
Decreasing CT scan use, improving PICU safety and minimizing transcription costs
Clinicians at Children’s National, a 313-bed hospital in Washington, D.C., care for some of the most complex critically ill children in the region. By working with the Bear Institute for Health Innovation and investing in the hospital’s IT infrastructure, clinicians have address some of the biggest issues the organization faced.
For instance, after a 2,000 percent increase in pediatric computerized tomography (CT) scans nationally between 1995 and 2003, Children’s National confronted the expensive radioactive practice. Emergency department staff built a workflow that more accurately prescribed the necessity of the practice, achieving a 44 percent relative reduction in CT scans.
In addition, Children’s National improved safety within its pediatric intensive care unit (PICU) by implementing what they called “Quality Boards” that dramatically improved safety within its PICU. These digital dashboards not only helped decrease the average time from admission to treatment consent by 49 percent, but they also helped parents become part of each child’s care team. The organization also implemented an ambulatory electronic health record (EHR), which included voice recognition technology, effectively minimizing transcription costs and expediting the availability of physician notes.
For these successes, Children’s National received the 2017 HIMSS Enterprise Davies Award, one of the highest honors in health IT, recognizing “outstanding achievement” in the use of health IT to “substantially improve patient outcomes and value.”
“We are so honored to receive this important recognition, which represents over 10 years of hard work from hundreds of staff here at Children’s National. Our investments in people, processes, technology and innovation are making a remarkable difference in the quality of care that we are providing to our children and their families.” – Dr. Brian Jacobs, vice president, chief medical information officer and chief information officer at Children’s National
Get a glimpse into how Children’s National wants to use informatics in the future:
Transforming pediatric care and exploring ways to improve outcomes
Children’s Hospital of Orange County (CHOC Children’s) has long been a leader dedicated to improving the health of its population by advancing interoperability and automating care management processes across the health system.
From 2005 to 2014, CHOC Children’s cut its central line-associated blood stream infection rate by more than 85 percent while seeing dramatic decreases in morbidity and mortality rates.
In addition, the hospital successfully interfaced breast-feeding orders and bar code scanning to prevent hundreds of breast milk administration errors. In less than five years, the health system dramatically reduced labeling and storage errors while all but eradicating expired and “wrong milk” administrations.
In January 2017, CHOC Children’s achieved HIMSS Acute Stage 7 Award, which distinguishes the highest level on the Electronic Medical Records Adoption ModelSM (EMRAM), which is used to track EHR progress at hospitals and health systems.
“Industry buzz aside, at the end of the day, it’s not about advancing IT. It’s about creating a safe and effective care environment for the children we serve.” – Dr. William Feaster, chief medical information officer at CHOC
Hear Feaster’s thoughts on attaining this organizational milestone:
NICU automates the management of mother’s milk and formula
Children’s Hospital of Georgia (CHOG) at Augusta University Health has the region’s premiere neonatal intensive care unit (NICU). In fact, it has the only Level IV NICU (highest level) in an 18-county region in Georgia and South Carolina. Keeping the infants in the NICU nourished and keeping their families comfortable are among the NICU’s biggest priorities, making it critical to get the appropriate breast milk to the right baby in a timely manner.
In December 2015, the organization implemented a milk and formula management solution, which has since achieved 100 percent accuracy in the management of mother’s milk. The solution included a barcode scanning solution and effectively controlled the handling process from collection and storage through preparation and administration. Between its implementation and June 2016, nurses effectively reduced instances of expired milk by 63 percent, while reducing improperly matched milk by 25 percent.
Not only were the mothers intimately involved in the care of their own children, but the nurses had more time to devote to the children under their care. Thanks in part to these improvements, the organization reached Stage 7 on the HIMSS Analytics EMRAM in July 2016.
“The NICU is able to confirm that the right baby gets the right breast milk at the right time, every time. Families can find comfort that their baby is getting the proper nourishment even in a difficult situation.” – Ruth Wilson, nurse manager at CHOG
Falls prevention program protects children from avoidable injury
The Joint Commission identifies inpatient falls as a significant patient safety risk. Because of this, organizations are required to have a fall reduction program with interventions in place. Although fall protocols are typically geared toward adults, children tend to be curious and restless, making them particularly prone to falls during hospital stays.
In response, Nicklaus Children’s Hospital, a branch of Miami Children’s Health System, implemented an evidence-based falls prevention program uniquely addressing fall prevention for children. The hospital successfully reduced its falls rate by 41 percent with its globally acclaimed Humpty Dumpty Falls Prevention Program™. Nicklaus Children’s uses its EHR to assess a patient’s age, diagnosis, cognitive impairments, medication usage and operating room or surgery transfers in order to assess their numerical fall risk. After this risk assessment is complete, the nursing staff is able to take the necessary steps to prevent further fall risks.
Today, more than 1,150 hospitals around the world have implemented the Humpty Dumpty Falls Assessment scale and tools. The program has been translated into five languages and is in use in 18 countries across six continents.
“We are hoping after winning our Magnet Prize at the ANCC Magnet Conference, we will continue to spread the wealth of this program and impact the pediatric patients that we serve.” – Laura Hernandez, MSN, ARNP, FNP-BC, CPN, nurse practitioner and pediatric educator at Nicklaus Children’s
See how Nicklaus Children’s has remained a leader in health care:
Cerner provides pediatric care teams with a complete, integrated electronic health record, bringing together information that spans the foundational years of our children’s lives. Read more about our pediatrics solutions here.