BOOK
Quality of Care and Information Technology, An Issue of Pediatric Clinics of North America, E-Book
(2016)
Additional Information
Book Details
Abstract
The Guest Editor of this issue is a pediatric emergency medicine specialist and the Chief Medical Officer at Children’s Hospital of Pittsburgh. He is very involved in the medical record and other electronic devices as safety measures. He brings his expertise and breadth of knowledge to the Pediatric Clinics of North America to assemble a stand out list of authors who have contributed articles on Pediatric Safety, Quality & Informatics. In this issue, articles are devoted to Big Data and the role of Predictive Analytics in Pediatrics; Research in Pediatric IT- the present and the future; Quality Care and Patient Safety in the pediatric emergency department; Safety & Quality metrics for Pediatric Hospital Medicine; Clinical Effectiveness Guidelines- Easy to Create but Hard to Implement; Advanced Technology in the pediatric ICUs; Measurement, Standards and Peer Benchmarking in Pediatric Safety & Quality: One hospital’s journey; Clinical Informatics and its role in the care of children; Pediatric Safety & Quality: A nursing perspective; Pediatric Telehealth: opportunities and challenges; and Fundamentals of Quality Improvement: How to do pediatric QI research.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Quality of Care and\rInformation Technology | i | ||
| Copyright | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iii | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| CONSULTING EDITOR | v | ||
| EDITOR | v | ||
| AUTHORS | v | ||
| Contents | ix | ||
| Foreword: Pediatric Safety, Quality, and Informatics | ix | ||
| Preface: The Intersection of Safety, Quality, and Informatics: Solving Problems in Pediatrics | ix | ||
| Population Health and Pediatric Informatics | ix | ||
| Measurement, Standards, and Peer Benchmarking: One Hospital’s Journey | ix | ||
| Electronic Health Record–Enabled Research in Children Using the Electronic Health Record for Clinical Discovery | ix | ||
| Quality Care and Patient Safety in the Pediatric Emergency Department | x | ||
| Patient Safety and Quality Metrics in Pediatric Hospital Medicine | x | ||
| Advanced Technology in Pediatric Intensive Care Units: Have They Improved Outcomes? | x | ||
| ABCs of Safety and Quality for the Pediatric Resident and Fellow | x | ||
| Clinical Pathways: Driving High-Reliability and High-Value Care | xi | ||
| Pediatric Quality and Safety: A Nursing Perspective | xi | ||
| Pediatric Quality Improvement: Practical and Scholarly Considerations | xi | ||
| Big Data and Predictive Analytics: Applications in the Care of Children | xi | ||
| Pediatric Telehealth: Opportunities and Challenges | xii | ||
| PEDIATRIC CLINICS OF\rNORTH AMERICA | xiii | ||
| FORTHCOMING ISSUES | xiii | ||
| June 2016 | xiii | ||
| August 2016 | xiii | ||
| October 2016 | xiii | ||
| December 2016 | xiii | ||
| RECENT ISSUES | xiii | ||
| February 2016 | xiii | ||
| December 2015 | xiii | ||
| October 2015 | xiii | ||
| August 2015 | xiii | ||
| Foreword:\rPediatric Safety, Quality, and Informatics | xv | ||
| Preface:\rThe Intersection of Safety, Quality, and Informatics: Solving Problems in Pediatrics | xvii | ||
| REFERENCES | xviii | ||
| Population Health and Pediatric Informatics | 221 | ||
| Key points | 221 | ||
| INTRODUCTION | 221 | ||
| WHAT IS POPULATION HEALTH? | 222 | ||
| THE DIGITAL DIVIDE | 222 | ||
| ALIGNMENT OF PEDIATRIC PRACTICE WITH POPULATION HEALTH | 224 | ||
| HOW HAS PEDIATRIC CARE AND POPULATION HEALTH BEEN SUPPORTED BY HEALTH INFORMATION TECHNOLOGY? | 224 | ||
| Electronic Medical Records and Clinical Decision Support | 228 | ||
| Meaningful use criteria for public health | 228 | ||
| Clinical decision support in pediatrics | 228 | ||
| Assessment and integration of clinical guidelines; prioritizing social determinants of health | 228 | ||
| Use of the electronic medical records demographic features to predict and provide medical care | 229 | ||
| Electronic Health Tools for Consumers | 230 | ||
| Population Health Information Systems | 231 | ||
| Health Information Exchange | 232 | ||
| CHALLENGES IN USING HEALTH IT TO PROMOTE POPULATION HEALTH | 233 | ||
| FUTURE DIRECTIONS | 235 | ||
| REFERENCES | 235 | ||
| Measurement, Standards, and Peer Benchmarking: One Hospital's Journey | 239 | ||
| Key points | 239 | ||
| INTRODUCTION | 239 | ||
| HISTORY OF MEASUREMENT, STANDARDS, AND BENCHMARKING IN PEDIATRICS | 240 | ||
| SOLUTIONS FOR PATIENT SAFETY | 241 | ||
| GROUNDWORK FOR SUCCESS WITH SOLUTIONS FOR PATIENTS SAFETY | 242 | ||
| Infrastructure: Data | 244 | ||
| Organizational Structure to Effect Change | 244 | ||
| Tools for Provider Engagement with Benchmarking | 245 | ||
| Institutional Culture | 245 | ||
| RISK/BENEFIT FOR PARTICIPATING HOSPITALS | 245 | ||
| CHILDREN’S HOSPITAL OF PITTSBURGH OF UNIVERSITY OF PITTSBURGH MEDICAL CENTER’S EXPERIENCE WITH SOLUTIONS FOR PATIENT SAFETY | 246 | ||
| SUMMARY | 248 | ||
| REFERENCES | 248 | ||
| Electronic Health Record–Enabled Research in Children Using the Electronic Health Record for Clinical Discovery | 251 | ||
| Key points | 251 | ||
| INTRODUCTION | 252 | ||
| THE ELECTRONIC HEALTH RECORD DATA SET | 252 | ||
| Electronic Health Record Data Elements | 252 | ||
| Electronic Health Record Data Validation/Corroboration | 253 | ||
| ELECTRONIC HEALTH RECORD–ENABLED RESEARCH METHODOLOGIES AND EXAMPLES OF ANALYTICAL APPROACHES | 254 | ||
| Electronic Health Record–enabled Retrospective, Observational Research | 254 | ||
| Electronic Health Record–enabled Quality Improvement and Assessment of Interventional Impact | 260 | ||
| Electronic Health Record–enabled Prospective Research | 261 | ||
| LIMITATIONS SURROUNDING ELECTRONIC HEALTH RECORD–ENABLED RESEARCH | 262 | ||
| SUMMARY | 262 | ||
| REFERENCES | 263 | ||
| Quality Care and Patient Safety in the Pediatric Emergency Department | 269 | ||
| Key points | 269 | ||
| THE INSTITUTE OF MEDICINE’S CALL FOR IMPROVEMENT | 269 | ||
| QUALITY IMPROVEMENT FRAMEWORKS | 270 | ||
| QUALITY IMPROVEMENT METHODS AND TOOLS | 271 | ||
| SPECIFIC TOOLS FOR QUALITY IMPROVEMENT | 272 | ||
| EVIDENCE-BASED GUIDELINES AND THEIR ROLE IN QUALITY CARE | 275 | ||
| MEASURING QUALITY IN PEDIATRIC EMERGENCY MEDICINE | 276 | ||
| LOCAL EXAMPLES OF QUALITY IMPROVEMENT WORK IN A PEDIATRIC EMERGENCY DEPARTMENT | 277 | ||
| Emergency Department Time-out Vital Signs Check | 277 | ||
| Emergency Department Screening for Sexually Transmitted Infection | 278 | ||
| Emergency Department Management of Sexual Assault Referrals | 278 | ||
| COLLABORATIVE DEVELOPMENT OF SAFETY FOR CHILDREN AT RISK FOR SEPTIC SHOCK | 278 | ||
| SUMMARY | 281 | ||
| ACKNOWLEDGMENTS | 281 | ||
| REFERENCES | 281 | ||
| Patient Safety and Quality Metrics in Pediatric Hospital Medicine | 283 | ||
| Key points | 283 | ||
| INTRODUCTION | 283 | ||
| THE QUALITY ASSURANCE MOVEMENT | 284 | ||
| PEDIATRIC HOSPITAL MEDICINE AND INPATIENT HEALTH CARE | 284 | ||
| QUANTIFICATION | 285 | ||
| Descriptive Data | 285 | ||
| Clinical Quality Data | 285 | ||
| Nonclinical Quality Data | 286 | ||
| Productivity Measures Data | 286 | ||
| Resource Utilization Data | 286 | ||
| Group Sustainability Data | 286 | ||
| MEDICATION ERRORS IN HOSPITALIZED CHILDREN | 286 | ||
| MULTIDISCIPLINARY APPROACH TO REDUCE ERRORS | 287 | ||
| PROSPECTIVE METRICS FOR PEDIATRIC HOSPITAL MEDICINE | 287 | ||
| CHILDREN’S HOSPITAL OF MICHIGAN’S SAFETY CULTURE | 287 | ||
| INPATIENT SAFETY ROUNDING TOOL | 288 | ||
| IMPROVING INPATIENT ASTHMA CARE AND PREVENTING ASTHMA READMISSIONS | 288 | ||
| HAND HYGIENE MEASURES | 288 | ||
| OTHER METRICS | 290 | ||
| SUMMARY | 290 | ||
| REFERENCES | 291 | ||
| Advanced Technology in Pediatric Intensive Care Units | 293 | ||
| Key points | 293 | ||
| INTRODUCTION | 293 | ||
| ELECTRONIC MEDICAL RECORDS | 294 | ||
| COMPUTERIZED PROVIDER ORDER ENTRY AND CLINICAL DECISION SUPPORT | 295 | ||
| Computerized Provider Order Entry | 295 | ||
| Clinical Decision Support | 295 | ||
| TELEMEDICINE AND REMOTE INTENSIVE CARE UNIT MONITORING | 295 | ||
| DATA TRENDING AND REVIEW | 296 | ||
| BIG DATA AND PREDICTIVE ANALYTICS | 296 | ||
| OUTCOMES | 297 | ||
| SUMMARY | 297 | ||
| REFERENCES | 298 | ||
| ABCs of Safety and Quality for the Pediatric Resident and Fellow | 303 | ||
| Key points | 303 | ||
| INTRODUCTION | 303 | ||
| PATIENT SAFETY AND QUALITY IMPROVEMENT AS PART OF GRADUATE MEDICAL EDUCATION | 304 | ||
| THE CLINICAL LEARNING ENVIRONMENT: THE FOUNDATION OF QUALITY IMPROVEMENT IN MEDICAL EDUCATION | 306 | ||
| CURRICULAR APPROACHES TO TEACHING QUALITY IMPROVEMENT AND PATIENT SAFETY | 307 | ||
| EXPERIENCES IN TEACHING QUALITY IMPROVEMENT AND SAFETY TO PEDIATRIC TRAINEES | 308 | ||
| STATE OF QUALITY IMPROVEMENT AND PATIENT SAFETY EDUCATION IN PEDIATRIC GRADUATE MEDICAL EDUCATION | 311 | ||
| SUMMARY | 313 | ||
| REFERENCES | 313 | ||
| Clinical Pathways | 317 | ||
| Key points | 317 | ||
| INTRODUCTION | 318 | ||
| Making a Case for Pathways: a Rapidly Changing Environment and its Effect on the Evolution of Health Care | 318 | ||
| Clinical Pathways Defined—Beyond the Algorithm | 319 | ||
| INTERDISCIPLINARY AND MULTIDISCIPLINARY | 320 | ||
| ACROSS THE CONTINUUM OF CARE | 321 | ||
| CHANNELING GUIDELINES AND EVIDENCE | 321 | ||
| MEASUREMENT BEYOND THE OUTCOMES | 321 | ||
| STRATEGIC ALIGNMENT | 322 | ||
| GETTING TO THE FUTURE STATE: CLINICAL PATHWAYS MAPPING THE WAY TO HIGH-VALUE CARE | 322 | ||
| PATIENT SAFETY, EFFECTIVENESS, AND EQUITABILITY | 322 | ||
| EFFICIENT AND TIMELY | 322 | ||
| PATIENT-CENTERED | 323 | ||
| PATHWAYS AS A STRATEGIC TOOL | 323 | ||
| HIGH-IMPACT WITH VIABLE STAKEHOLDERS | 324 | ||
| Organization | 324 | ||
| Executive Leadership | 324 | ||
| Physicians | 324 | ||
| Nurses and Hospital Staff | 324 | ||
| Patients and Families | 325 | ||
| The Pathway for Implementation Is Not Always Without its Roadblocks… | 325 | ||
| SUMMARY: SUCCESSFUL CLINICAL PATHWAY IMPLEMENTATION AND SUSTAINABILITY | 326 | ||
| REFERENCES | 326 | ||
| Pediatric Quality and Safety | 329 | ||
| Key points | 329 | ||
| INTRODUCTION | 329 | ||
| WHAT DOES IT MEAN TO PROVIDE SAFE AND QUALITY NURSING CARE? | 330 | ||
| SAFETY AND QUALITY ARE AT THE CORE OF NURSING PRACTICE | 330 | ||
| HIGH COST DOES NOT EQUATE TO HIGH QUALITY | 330 | ||
| POOR QUALITY OF CARE MAY PERPETUATE COSTS | 332 | ||
| NURSES NAVIGATING AN EVOLVING ECONOMIC AND REGULATORY LANDSCAPE | 332 | ||
| IMPORTANCE OF NURSE LEADERS DRIVING THE CULTURE OF A HIGH-RELIABILITY ORGANIZATION | 333 | ||
| SOLUTIONS FOR PATIENT SAFETY: A UNIQUE OPPORTUNITY FOR PEDIATRICS | 334 | ||
| FRONTLINE NURSES AND PHYSICIANS DRIVING SAFETY AND QUALITY TO REACH OUTCOMES | 336 | ||
| SUMMARY | 338 | ||
| REFERENCES | 338 | ||
| Pediatric Quality Improvement | 341 | ||
| Key points | 341 | ||
| WHAT IS HEALTH-CARE QUALITY? | 341 | ||
| QUALITY IMPROVEMENT, RESEARCH, AND QUALITY IMPROVEMENT RESEARCH | 342 | ||
| MODELS FOR UNDERSTANDING QUALITY | 344 | ||
| THE SCIENCE OF QUALITY IMPROVEMENT | 347 | ||
| STATISTICAL METHODS IN QUALITY IMPROVEMENT RESEARCH AND A PRIMER IN STATISTICAL PROCESS CONTROL | 350 | ||
| SUMMARY | 352 | ||
| REFERENCES | 352 | ||
| Big Data and Predictive Analytics | 357 | ||
| Key points | 357 | ||
| DEFINITION OF ANALYTICS AND ITS IMPACT ON HEALTH CARE | 358 | ||
| ANALYTICS IN THE FORM OF DECISION SUPPORT AND MONITORING SYSTEMS | 358 | ||
| ARCHITECTURAL FRAMEWORK | 359 | ||
| DATA SCIENTISTS | 360 | ||
| ANALYTICS IN HOSPITAL OPERATIONS | 360 | ||
| ADVANCED ANALYTICS/CLINICAL DECISION SUPPORT | 360 | ||
| GENOMICS AND BIG DATA | 361 | ||
| THE PERSONALIZED MEDICINE COALITION | 363 | ||
| IMPACT ON DIAGNOSTIC IMAGING | 364 | ||
| CHALLENGES AND FUTURE OF ANALYTICS IN HEALTH CARE | 364 | ||
| THE SPECIALTY OF CLINICAL INFORMATICS AND BOARD CERTIFICATION | 364 | ||
| IMPACT ON QUALITY OF LIFE | 365 | ||
| REFERENCES | 365 | ||
| Pediatric Telehealth | 367 | ||
| Key points | 367 | ||
| INTRODUCTION | 367 | ||
| DEFINING TELEHEALTH | 368 | ||
| CLASSIFYING TELEHEALTH SERVICES | 368 | ||
| OPPORTUNITIES TO IMPROVE QUALITY OF CARE AND PATIENT SAFETY | 369 | ||
| Patient Access to Care | 369 | ||
| Provider Outreach | 370 | ||
| Patient, Family, and Provider Education | 371 | ||
| Resource Utilization | 371 | ||
| CHALLENGES TO THE ADOPTION OF TELEHEALTH | 372 | ||
| Technological Barriers | 372 | ||
| Provider Concerns | 373 | ||
| Patient Concerns | 374 | ||
| Financial Barriers | 374 | ||
| Credentialing and Licensing Barriers | 374 | ||
| Legal Concerns | 375 | ||
| SUMMARY | 375 | ||
| REFERENCES | 376 | ||
| Index | 379 |