This contributed Q&A is the second in a content series as a lead-in to Becker’s 9th Annual CEO+CFO Roundtable: Nov. 9-11, 2020.
During this premier gathering of the country’s most accomplished healthcare executives, Becker’s will present the inaugural Future of Pediatric Healthcare Forum in collaboration with Phoenix Children’s and other leading pediatric health systems.
Phoenix Children’s is honored to work with Becker’s in elevating the conversation of pediatrics as a substantive component of the overall healthcare value chain. Over the next several months, we are excited to bring you a robust offering of informative and insightful pediatric content. We encourage healthcare leaders to engage in the dialogue and participate in The Future of Pediatric Healthcare Forum by RSVP'ing here.
The Future of Pediatric Healthcare Forum will feature a session on Reporting and Transparency of Pediatric Outcomes.
Outcomes reporting continues to be an important topic in healthcare. For Phoenix Children’s, it’s a core component of the health system’s long-term strategy to improve patient care.
The organization reports to The Leapfrog Group, Society of Thoracic Surgeons, Solutions for Patient Safety and numerous other national groups that review data on patient safety, quality and outcomes and rate children’s hospitals across the country. Not only does this keep health systems accountable, but Phoenix Children’s says it makes a direct and measurable difference on patient care.
Unfortunately, too few healthcare organizations publicly report their data. Given the sheer volume of patient data health systems amass, many institutions struggle with how to leverage this information to benefit their patients, let alone share it publicly. Others choose not to publicly report their outcomes because their data isn’t as good as they hoped. Perhaps there are problems they don’t want to expose or they’re concerned about losing potential patients.
Phoenix Children’s IT department and clinicians work together to design systems that collect and translate huge quantities of data and distill it down into actionable insights to guide patient care. This information sharing fuels success in medication monitoring, risk prediction and patient safety, among other interventions. It also makes it easier to continually measure and improve outcomes.
The hope is that transparency becomes the standard among hospital systems for the benefit of all those involved. Payers need this information to create plans for their members. Savvy consumers seek out this information as they navigate the healthcare system. Indeed, amid a global health crisis, outcomes reporting has never been more important.
This Q&A provides more information about Phoenix Children’s efforts to improve transparency in pediatric care; a discussion that will evolve at the Pediatric Healthcare Forum in November.
Question # 1: How does outcomes reporting improve quality and safety efforts for patients?
Dr. Ritchey: Every day, we encounter parents facing some of the worst days of their lives. Their children are sick or hurt, and they’re desperate for quick and competent intervention. Many patient families do not know data and quality metrics are available – that they can check the record for many areas of care – so we make a conscious effort to arm them with any data and figures they need.
We also report a trove of data to 37 national quality and safety databases. One of our biggest reporting platforms is Solutions for Patient Safety (SPS), an organization comprised of 135 children’s hospitals working toward a future of zero harm for pediatric patients. One benefit here is SPS shares information freely among hospitals, which allows us to learn from one another and elevate pediatric care on a national scale.
The opportunity to benchmark against other institutions is invaluable. We also participate with Leapfrog, a watchdog organization that tracks safety and quality metrics for hospitals across the U.S. It has been an incredible honor for Phoenix Children’s to receive “Top Children’s Hospital” recognition from Leapfrog. Earning this distinction is extremely challenging, and very few institutions meet the requirements. In 2018, Phoenix Children’s was the only Arizona health system to be recognized by Leapfrog.
In the future, our plan is to share outcomes on our website, PhoenixChildrens.org, to make it easy for parents and community members to access the information they need.
Dr. Vaidya: My role is to create technology solutions that harness data to improve patient care. This effort began several years ago with our data lake repository, which collects data from all corners of the organization and powers patient care dashboards that have dramatically improved safety and quality.
For example, our Kidney Monitoring System gauges kidney function of every hospital patient. Our Pediatric Dose Range Checking System issues a hard stop when a prescribed dose falls outside the safe range. Other systems monitor for sepsis, IV infiltration and other hospital-acquired conditions.
Early warning alerts prompt providers to take action to prevent any adverse outcomes. Care teams use these dashboards during daily patient safety rounds in all high-reliability units to monitor compliance with care bundles and intervene in real time.
Public reporting is simply an extension of Phoenix Children’s own internal efforts to improve.
Question #2: Is this level of transparency a common practice across pediatric health systems nationwide?
Dr. Ritchey: There is considerable variation among pediatric hospitals when it comes to outcomes reporting. For example, with SPS, most children’s hospitals participate, but they aren’t required to report the same data. You can choose the areas of reporting where you want to participate. We choose to report as much data as possible.
Another important reporting platform is the Child Health Patient Safety Organization (PSO). With PSO, health systems share information on safety issues and work together on solutions to eliminate preventable harm. Only 50 children’s hospitals currently participate – less than 20% nationwide.
For some specialties, outcomes reporting is not optional. For example, all cardiac surgery programs must report outcomes to the Society for Thoracic Surgeons (STS). For the past seven years, our surgical team has earned an STS top rating for congenital heart surgery outcomes – one of only 10 children’s hospitals in the nation. Hospitals also are required to report bone marrow transplant outcomes. This ongoing focus on outcomes has led our transplant program to achieve survival rates that are in the top 10% nationally.
Still, it’s not enough to rest on our laurels. We are constantly working to improve. This means evaluating our outcomes continually to ensure we’re providing the best possible care. It also means addressing any adverse situations to learn what must be done to mitigate future issues and safeguard our patients’ health.
Question #3: How do your IT systems support transparency in outcomes?
Dr. Vaidya: Our dashboards make it much easier for providers to adhere to patient care protocols and this ultimately improves safety and outcomes.
Our data lake drives our dashboards, which are updated as frequently as every 30 minutes. Updated EMR data feeds our data lake every 6-10 seconds, which allows us to derive insights and make clinical decisions in real time. This is helpful for all patients, but it’s critically important for kids who have complex or life-threatening conditions. Our providers need information right away – not in 24 hours – in order to make critical decisions for patient care.
Over the past few years, we have focused on real-time data alongside robust clinical decision support. Our dashboards include built-in monitoring and alert systems that enable providers to intervene before injury occurs. For example, less than one year after implementing the Kidney Monitoring System, the hospital saw a 60% reduction in acute kidney injury. It’s proof that with data transparency, our clinical population – physicians, nurses and pharmacists – can make better decisions on patient care.
Dr. Ritchey: The patient safety dashboards are as crucial to our health system as our EMR. They allow us to monitor our progress and improvements on an ongoing basis.
Question #4: Why is transparency an important consideration for payers?
Dr. Ritchey: Health insurers are increasingly focused on outcomes-based quality measures. For example, payers like Blue Cross & Blue Shield and UnitedHealth ask us to report data on readmission, utilization rates and other outcomes, which ultimately factor into the calculation of reimbursement rates. Dr. Vaidya provides the data we need to run our business most effectively. With the transition to value-based care, the executive team understands the importance of using data to inform us of options to meet our goals and targets.
Question #5: As Phoenix Children’s expands its footprint, how do reporting and transparency scale?
Dr. Vaidya: From a technological point of view, the scaling is simple. It’s like sending an email to three recipients or 3,000; ramping up reporting and transparency in data will easily scale as our health system expands.
In addition, we will amass more data as we continue to grow, creating an intelligence reservoir that will improve our dashboards and other systems.
Dr. Ritchey: The challenge here is scaling from an operational and clinical point of view. This means continual efforts to educate clinicians and foster a culture of transparency.
Question #6: What would it mean if transparency became the norm in pediatric practice?
Dr. Ritchey: Ideally, a patient family should have easy access to a hospital’s outcomes in any specialty area. Our belief is that parents are partners. Together, we make better decisions for children by engaging in open and honest discussions about a child’s options, the risks involved and our track record.
Dr. Vaidya: Ultimately, consumers will demand accountability and transparency in healthcare.
As providers, we should be asking ourselves: What can we do right now to improve the landscape in the future?
Phoenix Children’s is committed to the health and well-being of all children. We look forward to collaborating and sharing information, insights and best practices with the Becker’s community and patrons of Becker's 2020 CEO/CFO Roundtable: The Future of Pediatric Healthcare Forum.
If you enjoyed Reporting and Transparency in Pediatric Outcomes, please look for our next content piece: Clinical Integration in Pediatrics. We look forward to seeing you in November!
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