| Primary Author: | Marilyn J. Hockenberry, PhD, RN, PNP-BC, FAAN |
| Co-Principal Investigators/Collaborators: | Kathy McCarthy, Heidi Russell, Olga A. Taylor, Patricia Baxter |
| Organization: | Baylor College of Medicine, Pediatrics |
Abstract
Background
As cure for childhood cancer becomes reality, measures of success must keep pace with national initiatives designed to improve child health care quality and safety. A Quality Transformation (QT) Core was established within a major children’s cancer center to develop/monitor empirical outcomes that demonstrate excellence in all aspects of clinical care. QT Core is based on the Institute of Medicine’s rules for quality health care that ensures care is safe, effective, patient-centered, timely, efficient and equitable.
Purpose
Specific goals for the first year of the QT Core were to develop a team of improvement science experts, engage faculty and staff in QT initiatives promote accountability for excellence in clinical care and establish specific metrics to evaluate process, structure and outcomes.
Methods
QT Core members include 24 individuals from medicine, nursing, pharmacy, child life and social services. Key to the team is nursing leadership and staff from patient registration, billing and scheduling. A manual was developed to standardize operating procedures and orient members to the QT Core. Nine QT Core members completed a six-month advanced quality improvement course and serve as project leads.
Results
During this first year 13 projects were implemented, six focusing on process/structure changes and seven evaluating specific outcome measures related to quality clinical care. Examples of process/structure initiatives include improving office-visit efficiency, defining acuity within our urgent-care clinic, and decreasing wait-time for new hematology referrals. Outcome projects focus on implementing evidence-based guidelines designed to decrease care variation; examples include managing fever and neutropenia, central line catheter infections, sickle cell acute chest and sedation for procedures. A QT Core dashboard displays all projects and outcome measures.
Conclusion
The future is bright for continued progress toward childhood cancer cure. As the journey toward cure continues, the specialty must keep pace with national initiatives that promote quality in clinical care. The QT Core within this children’s cancer center is changing the way excellence in clinical outcomes are measured.
© Improvement Science Research Network, 2011