How It All Started
2005: The beginning of an idea…
The Ohio Children’s Hospital Association (OCHA) is a group of six children’s hospitals that organized in the 1980s to advocate for appropriate reimbursement of pediatric health care in Ohio and other legislative and regulatory issues affecting children’s health care.
Over time, OCHA‘s aim broadened to emphasize quality and safety issues for children. Project-specific process improvement work within OCHA began in 2005 with an initiative to develop and implement medical response teams in all OCHA hospitals. The goal of this initiative was to eliminate preventable cardiac and cardiopulmonary arrests outside the intensive care units. The collaborative achieved a 46 percent reduction across all hospitals.
At that time, the Ohio Department of Health Hospital Advisory Committee was developing a set of quality measures for public reporting, and the state asked OCHA to make detailed recommendations regarding the measures for pediatrics. In doing so, OCHA reached out to the two other children’s hospitals in Ohio that weren’t historically part of the original organization and developed consensus recommendations for the five pediatric quality measures that were ultimately adopted by the state. This effort not only resulted in publicly reported measures, developed and endorsed by the doctors and nurses of the state’s children’s hospitals, but also was the origin of the next phase of improvement work.
2009: The launch of a statewide collaborative
As a result of collaboration with Ohio state officials and the Ohio Department of Health, the Ohio collaborative expanded to include all eight pediatric referral centers and to focus on additional quality improvement projects. With this expanded effort and with all Ohio children’s hospitals participating, the Ohio Children’s Hospitals Solutions for Patient Safety (OCHSPS) network was launched in early 2009.
This learning and improvement network was initially designed to tackle two critically important (and now publicly reported) pediatric healthcare measures — surgical site infections (SSI) and adverse drug events (ADE). Importantly and for the first time, this new OCHSPS work was financially supported by private industry as OCHSPS garnered the attention of the Ohio Business Roundtable and large employers in the state, most notably Cardinal Health. This public-private partnership proved critical to the success of both projects as well as future work.
Through the use of standard definitions; training in the Model for Improvement and Plan/Do/Study/Act cycles; the creation, implementation and measurement of event prevention bundles; data analysis and transparency across the collaborative, hospitals learned in real time from the best performing organizations within the collaborative. As a result, SSIs in high risk children were reduced by 60 percent and ADEs were reduced by 50% across all eight children’s hospitals in Ohio.
2010: Setting the bar high
As the ADE and SSI projects achieved marked improvement, OCHSPS leaders began to appreciate the power of the collaborative effort and determined they would establish a bold, audacious goal: to be the safest state in the country for children to receive healthcare. The general aim was to eliminate serious harm in the State of Ohio by the end of 2015. During a meeting in early 2010 attended by all hospital chief executive officers and hospital quality leaders as well as board quality members from most of the state’s children’s hospitals, a vote was taken and the collaborative’s goal and aim were unanimously endorsed. Work then began to establish the administrative, clinical and legal structure to allow the organization to pursue its goal and aim. By 2011, OCHSPS had reduced serious safety events by 55 percent and serious harm events by 40 percent.
2011 – 2013: Ohio exports its work and creates a national network
After achieving significant results in the state, Ohio’s children’s hospitals were asked in 2011 to lead a national effort to implement the strategies they created in children’s hospitals throughout the country.
In 2012, 25 hospitals from across the nation joined the initial 8 Ohio hospitals in the first phase of the Children’s Hospital’s Solutions for Patient Safety (SPS) network.
In 2013, the network grew to 78 hospitals in 33 states and Washington, DC. Also in 2013, SPS partnered with Child Health Patient Safety Organization (PSO), the nation’s only PSO dedicated to children’s hospitals. Affiliated with Children’s Hospital Association, Child Health PSO enables confidential learning from reported safety events with the added benefit of federal privilege protections. This partnership has demonstrated reductions in preventable harm to children and is now available to more than 75 hospitals in 33 states and Washington, D.C. (For more information about the Child Health PSO, contact Kate Conrad at Children’s Hospital Association (firstname.lastname@example.org or 913-262-1436).
2014 – 2017: SPS evolves and goes international
In 2014, SPS revised its structure. Through the development and implementation of effective prevention standards, creation of a high reliability culture—similar to nuclear engineering and naval aviation—and partnering with patients and families, network hospitals are working to achieve specific goals. The SPS network supports participating hospitals on their journey toward zero harm by providing frequent training and learning opportunities, tools, data collection and analysis, opportunities to collaborate, and much more. The network has grown to include 80+ children’s hospitals nationwide.
In 2015, the network expanded internationally into Canada. The network has grown to include 135+ children’s hospitals.
In the meantime, the eight original Ohio children’s hospitals continue to collaborate and lead the country through Ohio Children’s Hospitals’ Solutions for Patient Safety.