Ambulatory Safety
Children receive vastly more health care in the outpatient than in the inpatient setting. For every single inpatient visit, an estimated 28 outpatient visits occur.
Serious harm can happen in either setting, and preliminary data suggest that the outpatient setting may be even more complex and error-prone than the inpatient environment. The Network is focusing on two areas: Ambulatory Foundations and Ambulatory CLABSI. SPS has only begun its initial work on reducing harm in the ambulatory setting. As tools and resources are developed from the Network’s testing, they will be published here for public use.
For Network members only
Ambulatory Foundations
The SPS Network has established an Ambulatory Safety Foundation in children’s hospitals that will allow for the longitudinal reduction in harm. In addition, SPS will work closely with patients and families to develop and test interventions. The aim of the Ambulatory Safety Foundation’s work is to establish the structure for the development of foundational elements needed for network hospitals to address harm in the ambulatory setting.
Ambulatory CLABSI
SPS’s Ambulatory Central Line-Associated Blood Stream Infections (CLABSI) work aims to support the detection and reduction of Ambulatory CLABSI primarily in the ambulatory Hematology-Oncology and Intestinal Failure patient populations, including those receiving parenteral nutrition. A caregiver guide, tested across a cohort of children's hospitals, demonstrated reductions in Ambulatory CLABSI for both populations. Children's hospitals engaged caregivers in learning conversations to better understand the real-life experiences families faced when caring for their child’s central line following hospital discharge. These insights enabled hospitals to tailor and strengthen the implementation of the caregiver guide, ultimately boosting caregiver confidence and helping reduce Ambulatory CLABSI events. SPS has identified Ambulatory CLABSI as a priority harm for network-wide reduction, and to support these efforts, has defined and prioritized safety-critical tasks that will guide current and future harm prevention work.