Wellness, revolutionized. - Children's Hospital Central California

We allot resources where we need to improve the
most. “In addition to our success with the National
Patient Safety Goals, we tailor our improvement
program to focus on the areas that will prevent the
most harm to our special type of patients – children,”
said Dr. Lehman.
In 2009, Children’s piloted a “global trigger
tool” to measure and quantify levels of harm in
our hospital. The tool uses “triggers,” red flags in
patient charts that could signal a harmful event.
Children’s randomly selects several charts a month
from various areas of the Hospital and conducts a
systematic review to identify these harmful events.
Our goal is to use this system to monitor ourselves
and focus on outcomes to drive our patient safety
program.
But none of these efforts are accomplished
without the work of many. Organizations that
demonstrate the most progress know that commitment
to continuous improvement and patient safety
is everyone’s responsibility, and everyone at Children’s
Hospital embraces this concept.
More about performance improvement . . .
Changing the playing field.
2009 plan lays groundwork for launch of Maternal-Fetal Center.
Performance improvement is
often very focused on details.
At Children’s we improve a
lot of “forests” by carefully
working on one tree at a time.
But sometimes improvement
means looking at the bigger
picture, changing the landscape
in a major way.
Neonatal and prenatal
care have long been two of
our premier service areas.
Along with our Prenatal Diagnostic
Center to help identify
early problems, families
with high-risk pregnancies
have relied on our regional
Neonatal Intensive Care Unit
(NICU) to give their little
ones a better chance at life.
Our outcomes have been
excellent compared to peer
hospitals, and the quality
of care has put us amongst
the best in the country. That
said, we still developed a
plan to take us from “very
good” to “great.” Looking
at best-practices nationwide,
we decided to change our
approach to high-risk births,
to treat not just the child,
but the mother. So over the
past years we have worked
to lay the foundation for our
new Maternal-Fetal Center. In
2009 this included the recruitment
of Dr. Jeffrey Pietz as
chief of newborn medicine as
well as two perinatologists.
Dr. Armando Fuentes will be
Children’s medical director of
perinatology and be joined
by Dr. Beni Adeniji. This will
be part of a partnership with
Saint Agnes Medical Center,
where Children’s has operated
a level II NICU for almost 25
years. Saint Agnes received
the HealthGrades 2009/2010
Maternity Care Specialty
Excellence Award, a designation
that ranks them among
the top five percent of hospitals
nationwide for maternity
care services.
Studies have shown a
need for additional access to
perinatal care in our region.
The program will cover our
45,000 square-mile service
area, bringing this sort of
unified regional center to the
Valley for the first time.
In partnership with Saint
Agnes, Children’s will now
offer care from the point
that a high-risk pregnancy
is identified, through birth,
and enhancing the care we
offer into childhood and up
to adulthood. Children’s new
physicians come from environments
where perinatologists
and neonatolgists partner to
improve prenatal care.
“The partnership changes
emergencies into planned
situations,” said Dr. Pietz. “It
means all the doctors know
what to expect, the parents
know what to expect, and a
plan of care is being implemented
long before birth.”
Dr. Fuentes agreed. “A
baby is in the system from the
minute of diagnosis. We can
prepare the parents and take
steps to improve or prolong
the pregnancy. We can bring
in specialists and surgeons
and make sure the baby is
born with all the right care
available.”
Children’s introduction of
perinatologists into the pediatric
specialty environment is
a best-practice that no other
Valley hospital offers.
“Where I came from,”
said Dr. Pietz, “perinatologists
and neonatologists had
offices in the same building.
If there was need for an
immediate consultation, I
would drop what I was doing.
I would go to the perinatologist’s office and
talk to mom, help her understand what to
expect. Everyone gets involved in an open
dialogue, and the family gets a plan.”
That plan can include many of the pediatric
subspecialties at Children’s. Babies
resulting from high-risk pregnancies often
need advanced pediatric treatment or
surgery, and we have teams available for
nearly any kind of specialized care. It’s one of
the main reasons to bring this kind of service
inside of a major pediatric facility. Physicians
such as cardiologists and geneticists can also
play a key role in diagnosis.
Dr. Pietz is already on-hand and treating
patients in our NICU, and Dr. Fuentes and
Dr. Adeniji will join us in the summer of 2010.
The research and planning that has led to the
development of the Center is finally coming
to fruition, and over the next year you will
see the additional services come online,
augmenting the fantastic care that exists
today. The Maternal-Fetal Center at Children’s
Hospital Central California is an excellent
example of large-scale program change,
and it brings an unprecedented level of care
to the region’s babies - and their moms.
For more about Dr. Pietz’, Dr. Fuentes’ and Dr. Adeniji’s experience and expertise, go to ChildrensCentralCal.org.
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