TI Grantee Update: Ohio

Grant Recipient: Cincinnati Children’s Hospital Medical Center (CCHMC)

Title: Defining Quality Performance Measures for Pediatric Emergency Care
Project Period:

October 1, 2007, to September 30, 2010

Project Team: This multi-site project team is led by Evaline Alessandrini, MD, MSCE, (CCHMC) and includes: Elizabeth Alpern, MD, MSCE, and Kathy Shaw, MD, MSCE, (both from Children's Hospital of Philadelphia); Jim Chamberlain, MD, (Children’s National Medical Center); Mark Gorelick, MD, MSCE, (Children’s Hospital of Wisconsin); and Richard Ruddy, MD, and Kartik Varadarajan, MPH, (both of CCHMC).

Background: Assessing the quality of medical care and identifying opportunities for improvement of care is an important responsibility of medical professionals, as well as all health care facilities. Though children account for 20% of emergency care visits nationally, few measures have been defined for assessing the emergency care of pediatric patients.  This project seeks to improve pediatric emergency care through the consensus identification of pediatric emergency care performance measures and associated elements of documentation.

Providing a framework for the measurement of pediatric emergency care will facilitate national benchmarking as well as an opportunity for development of risk adjustment processes to facilitate better pediatric emergency care research.

Project Progress:

2009-2010 The expert panel collapses the 60 measures to 15 available in charting/electronic medical records for evaluation of pediatric emergency care.  Reseachers from the Pediatric Emergency Care Applied Research Network (PECARN) are surveyed to validate the availability of 15 data elements in electronic medical records.  Proposed data elements also are integrated into an electronic medical record design for pilot implementation and evaluation.

A PECARN research group is established to define a map for future pediatric research utilizing the defined performance measures and enhanced capabilities of determining pediatric risk adjustment.

An EMSC webcast takes place on November 2.  Additionally, a Pediatric Emergency Care Performance Improvement Toolkit is developed and will be posted to the EMSC National Resource Center website.

2008-2009 A review of the 200 measures results in the identification of 60 measures considered to cross all targets of quality pediatric emergency care.

2007-2008 An inventory of existing pediatric emergency care quality criteria is developed.  Approximately 200 measures of quality pediatric emergency care are isolated from the inventory. An expert multidisciplinary panel inclusive of physicians, nurses, and family members is recruited to review the measures.

Dissemination and Sustainability: Presentations:

  • Pediatric Academic Society Meeting – 2009
  • EMSC Program Meeting – 2009
  • Interagency Committee of Emergency Medicine – 2009
  • American Academy of Pediatrics' Section on Emergency Medicine Leadership Conference - 2010

  • One manuscript has been submitted for publication consideration and additional manuscripts are under development.
  • An online toolkit is developed and will be posted to the EMSC National Resource Center website.
  • Performance measures will be submitted to the Agency for Health Care Research and Quality Clearinghouse.