Wellness, revolutionized. - Children's Hospital Central California

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1
Keeping the focus on
improvement.
You’ve seen examples of high-quality care at Children’s Hospital
Central California for years. As the only regional tertiary pediatric
institution in this part of the state, we set the standard for
children’s healthcare. But like a high-performance athlete or
any perfection-minded individual, the Hospital has a hard time
accepting “good enough” when great remains achievable.
Even with the advancements to care we’ve made in the
Valley and the nation, we still look both internally and out to
the world medical community to measure our performance and
indentify improvement opportunities. The quality and safety of
the care we provide our little patients is strong motivation for a
focus on improvement, and the primary driver behind all of our
decisions.
Improvement opportunities can come to light in national
studies, like the Institute of Medicine’s report “To Err is Human”,
which gave solid examples of the alarming ways patients were
endangered by care systems throughout the country. Rather
than assume that we aren’t like those other facilities, Children’s
conducted (and continues to conduct) internal reviews of the
nationally identified problem areas. We’ve found valuable opportunities
to improve, to keep our patients from harm, and to take
another step towards perfection.
The Joint Commission surveys Children’s Hospital about every
three years, measuring our care at core levels, and we received
high praise from them in 2009. But we still work just as hard at
Children’s keeps looking inward,
creating paths to improved care.
their nationally-published care goals.
We participate in unit-based measurement
groups as well. Our neonatal
intensive care and pediatric intensive
care units belong to national cooperatives
consisting of similar hospitals and
units comparing outcomes data. These
groups also work on problems together,
sharing innovative methods to improve
care throughout the world. Finally, our
own staff are always aware of how well
we perform, and we value and protect any
individual who comes forward to point
out a need for improvement.
There are many ways to make
improvements once a need is identified,
but it really boils down to three areas -
people, systems and tools.
Improving tools and technology
is a constant process in healthcare
(pg. 29), while training and education
are the primary methods for improving
care provided by people (pg. 9). Systems,
however, are a different matter. Systems
are intended to make it easy to always do
We make Children’s Hospital as stress-free as
possible for kids and their families. Parents
become an important partner in safety,
joining us in our effort to keep their
child’s care error-free.
the right thing, to put caregivers in situations
where mistakes are very hard to
make.
The Joint Commission puts a high
value on systems. An example is the
“read back” methodology pioneered by
The Joint Commission and adopted by
Children’s Hospital a few years ago. The
system is simple - any caregiver (such as
a nurse) receiving verbal instruction from
a doctor must write it down and read it
back - always. This ensures that the caregiver
correctly received and understood
the instruction, and that the doctor hears
exactly what the caregiver is going to do.
By making this a system that everyone
uses, Children’s eliminates senseless
miscommunication that could result in
improper care. It is a system that works.
In 2009, Children’s continued to
identify opportunities and implement
training, systems and tools to improve
care, with positive results.