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Careful Messaging, Leveraging Data Key to Success of SPS in Children’s Hospitals Part of Larger Hospital Systems

Like many children’s hospitals within larger institutions, Cleveland Clinic Children’s had a lot of clinicians involved in treating patients who were not familiar with the transformational results SPS has realized in pediatric HAC prevention.

Getting early buy-in to require anyone who touches a pediatric patient go through Error Prevention training at the Clinic was fundamental to not only creating a culture of safety, but also in ensuring that the work the team was doing would be successful.

“When we make rules, we follow them, but buy-in was also important,” said Vera Hupertz, MD, Pediatric Institute Vice Chair of Quality & Safety, Medical Director of Pediatric Hepatology and Transplantation and Pediatric Gastroenterology, Hepatology & Nutrition at the Clinic.

“We had cooperation from the adult quality team to require the training, but what really made it stick was when the surgical residents and staff attending said ‘this is fabulous!’ once they had been through it,” shared Hupertz.

Buy-in was also important when it came to ensuring the children’s hospital had the resources it needed to do the safety work. According to the Clinic Children’s team, the key to this is data.

“The data gives us what we need to demonstrate the need for resources we request,” said Hupertz. “For example, when we needed IT to help us put in a hard stop to screen pediatric patients for VTE, there was some push back that perhaps VTE was not a big issue in our younger patient population. But when we showed that VTE is actually the 3rd highest HAC in our hospital – and the 4th highest in the nation based on SPS reporting – people were stunned. And we got the resources we needed. The data demonstrated the need.”

Along with the data, the presentation and choice of words is also critical to ensuring that the message is heard.

“What we found early on was that instead of saying ‘what we’ve learned from the collaborative,’ we say ‘what we have learned from working with other hospitals,’ and just that little nuance of messaging has had a significantly different, more positive response – which allows our other messages to be heard,” said Allan Cohn, CPHQ, Quality Director, Cleveland Clinic Children’s.

“It’s really important that you don’t say ‘Our priorities are x, y and z because that’s what SPS’s priorities are.’ Instead, we say ‘Our priorities are x, y and z and that’s why we are participating in SPS because it aligns with the priorities we have and work we are trying to do,” said Cohn.

This approach has helped the Cleveland Clinic Children’s team shine internally. In fact, at the Ohio Pediatric Quality Summit in February hosted by Cardinal Health in Columbus, Ohio, Hupertz shared that the other non-pediatric areas of the hospital are now looking to the Children’s patient safety program as a model for the rest of the institution. One specific example is the daily huddle.

“There has been broad adoption of the concept of huddles – from here in Cleveland to our  partners  in Abu Dhabi,” shared Amrit Gill MD, FAAP, Patient Safety Officer and Pediatric Hospitalist Cleveland Clinic Children’s. “We have really been the pioneers in  implementing the huddle and the daily safety brief in the Children’s hospital and these huddles have now been embraced throughout the hospital.”

The huddles are 5 to 8 minutes via phone and there are 20+ groups on the call each day, even though there was apprehension when they started that it would take too long. What participants have found is that it is time well spent.

However, it’s not always the children leading the adults. “Pressure Ulcers are really more prevalent with adult patients, so we were able to leverage our infrastructure and learn from our adult peers and then share those learnings with the SPS Network,” said Cohn.

When asked the secret to their success, Gill offered some straightforward advice, “Share your feel good stories with others. Make your work visible. Share your successes and let people steal shamelessly from you.”

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