Patient Safety Evidence Report

Patient Safety Evidence Report

Summary of the Healthcare Environment

My hospital is a 150-bed facility providing pediatric and family care. The facility has focused on adopting evidence-based approaches to ensure optimal patient safety and continuous quality improvement. We have partnered with the Agency for Healthcare Research and Quality (AHRQ) to create safety and quality standards for pediatric and family care hospitals. The AHRQ provides data and evidence-based tools to support evidence-based decision-making that improves the safety, quality, equitability, and accessibility of healthcare services. The AHRQ also provides various quality standards, including Prevention Quality Indicators (PQIs), Inpatient Quality Indicators (IQI), Patient Safety Indicators (PSI), and Pediatric Quality Indicators (PDI).

Quality Standards that Align with the Pediatric and Family Hospital

PQI 15: Asthma in Younger Adults Admission Rate

The first quality standard that aligns with the hospital’s vision and mission is the PQI 15: Asthma in Younger Adults Admission Rate, which specifically focuses on asthma among children. Noting that pediatric care services are the major focus of the health facility, this quality standard guides the healthcare providers in monitoring asthma admissions among children and young adults. This quality standard will help the facility determine patient demographics based on age and sex, the number of patients at a particular time, as well as number of readmissions. These data sets are crucial in making decisions related to resource and staff planning and allocations, as well as curative and preventative care planning.

PSI 17: Birth Trauma Rate – Injury to Neonate

The second quality standard is the PSI 17: Birth Trauma Rate – Injury to Neonate. This quality standard aligns with the hospital due to its focus on providing quality and effective pediatric care from childbirth to adolescence. Regardless of the safety of care provided during and after childbirth, the risk of neonate injury is never fully eliminated. According to birthinjuryguide.org, an estimated 2 percent of 29 out of 1,000 neonates in the United States have a birth injury or trauma due to misuse of instruments and improver handling (Langdon & Uribe, 2022). The PSI 17 helps monitor and identify risk factors and cases of neonate trauma and injuries and implements preventive approaches.

PSI 07: Central Venous Catheter-Related Blood Stream Infection Rate

The third quality standard that aligns with the hospital is the PSI 07: Central Venous Catheter-Related Blood Stream Infection Rate. Central Venous Catheter-Related Blood Stream Infection is a preventable healthcare-acquired infection (HAI) resulting from the entry of bacteria and germs into the bloodstream through a central line. HAIs such as central venous catheter-related bloodstream infections compromise the quality and safety of care and may negatively impact the reputation of the facility. Therefore, the quality standard can guide the facility’s management and healthcare providers to employ various strategies to reduce the risk of infections and improve care outcomes.

How the Quality Standard Aligns with the Safety Domain of Healthcare Quality

PQI 15: Asthma in Younger Adults Admission Rate

The PQI 15 aligns with the safety domain as it focuses on monitoring, preventing, and reducing the rates of hospital admissions related to pediatric asthma. Pediatric asthma admission rates are a critical measure of the quality of care provided to pediatric patients at the primary care level (Lut et al., 2021). Pediatric asthma admissions increase the risk of avoidable harm from complications as well as the medications provided.

PSI 17: Birth Trauma Rate – Injury to Neonate

Neonate injury is a major indicator of unsafe care in pediatric and neonate care settings. The PSI 17 aligns with the safety domain, providing safety indicators in neonate care. Such safety indicators can help identify and mitigate risks for harm and trauma during and after birth, as well as help restructure standard protocols for neonate handling. Therefore helping reduce birth trauma rates.

PSI 07: Central Venous Catheter-Related Blood Stream Infection Rate.

The PSI 07 aligns with the safety domain as it addresses a serious HAI. Central catheters are a major cause of frequent bloodstream infections, resulting in complications and potential patient harm (Ruiz-Giardin et al., 2019). Such HAIs also contribute to longer lengths of stay and unnecessary costs in care.

Measures for Effectiveness of the Quality Standard

PQI 15: Asthma in Younger Adults Admission Rate

The effectiveness of PQI 15 is measured through the analysis of hospital admission rates for pediatric asthma patients. The focus is on the number of new admissions, reduction in admissions rate, readmission rates, and avoided cases of admission.

PSI 17: Birth Trauma Rate – Injury to Neonate

The effectiveness of PSI 17 is measured through analysis of data on birth trauma rate with a focus on birth trauma per 1,000 live births, types of neonate injury, avoidable cases of neonate injury, and reduction rates of neonate injuries.

PSI 07: Central Venous Catheter-Related Blood Stream Infection Rate

The effectiveness of PSI 07 is measured based on reported data on related infections with a focus on the number of new infections, reduction in current and new central catheter-related infections, and related treatment outcomes.

2 Key Quality Drivers for Quality-Improvement Process

Two key drivers for the quality improvement process are training healthcare providers on patient safety and using technology in care delivery. Healthcare staff training improves their understanding of quality standards, setting patient care and safety protocols, and adherence to such protocols. It also improves the healthcare workers’ competencies in the development and implementation of evidence in practice for quality improvement.

Integrating technology-based systems in patient care can improve the quality improvement process by improving the efficiency of communication and collaboration among care providers and other stakeholders and providing data to support decision-making. Technology-based systems such as EHRs (electronic health records) improve patient safety by reducing errors in care (Tubaishat, 2017).

How Pursuing/Meeting Each Standard Improves Patient Safety and Quality Health Care

Pursuing and meeting each of the three standards significantly improves the safety and quality of healthcare in a number of ways, for instance. Meeting the PQI 15 can help improve the safety of the children as it focuses on addressing risk factors for pediatric asthma at the community level and avoiding or reducing the need for admission rates. It also improves the timeliness of treatment interventions to avoid harmful complications. Additionally, PSI 17 can help identify and mitigate risks for harm and trauma during and after birth as well as help restructure standard protocols for neonate handling, while PSI 07 can provide guidance on the implementation of evidence-based that reduce the central venous catheter-related bloodstream infections, and reduce associated harm and costs.

 References

Langdon, K., & Uribe, S. (2022). Birth Trauma. Birth Injury Guide. https://www.birthinjuryguide.org/causes/birth-trauma/

Lut, I., Lewis, K., Wijlaars, L., Gilbert, R., Fitzpatrick, T., Lu, H., Guttmann, A., Goldfield, S., Lei, S., Gunnlaugsson, G., Hrafn Jónsson, S., Mechtler, R., Gissler, M., Hjern, A., & Hardelid, P. (2021). Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison. Journal of Health Services Research & Policy, 26(4), 251. https://doi.org/10.1177/13558196211012732

Ruiz-Giardin, J. M., Ochoa Chamorro, I., Velázquez Riós, L., Jaqueti Aroca, J., Garciá Arata, M. I., Sanmartín López, J. V., & Guerrero Santillán, M. (2019). Bloodstream infections associated with central and peripheral venous catheters. BMC Infectious Diseases, 19(1), 1–9. https://doi.org/10.1186/S12879-019-4505-2/TABLES/3

Tubaishat, A. (2017). The effect of electronic health records on patient safety: A qualitative exploratory study. Https://Doi.Org/10.1080/17538157.2017.1398753, 44(1), 79–91. https://doi.org/10.1080/17538157.2017.1398753

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Patient Safety Evidence Report

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