QI in Clinical SettingsPediatric Collaborative Networks for Quality Improvement and Research
Section snippets
History of the Pediatric Collaborative Improvement Network Model
In 2002, the Quality in Pediatric Subspecialty Care workgroup, chartered by the American Board of Pediatrics (ABP), initially developed the model as a means to accelerate the translation of evidence into practice, to improve care and outcomes for children, and to serve as the gold standard for the performance in practice component of Maintenance of Certification (MOC) requirements for subspecialty practice.6 This model built on successful examples of cooperative multisite clinical efforts that
How Pediatric Improvement Networks Work
Many of the features of pediatric collaborative improvement networks are derived at least in part from the Breakthrough Series model, the Institute for Healthcare Improvement's collaborative model for achieving improvement6:
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Focus on a high-impact condition, health topic, or safety issue that can affect patient outcomes, engage caregivers, and address a key population group, and that is a widely recognized problem.
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Obtain support from both clinical content and quality improvement experts who
Research in Collaborative Improvement Networks
In addition to a key focus on quality improvement, networks provide a strong foundation for research, which includes: 1) a robust data infrastructure; 2) standardization of care processes to reduce practice-to-practice variation, thereby increasing the ability to detect the impact of changes; and 3) a mechanism to engage all the key stakeholders– patients, families, clinicians, and researchers–in testing changes at the site of care delivery.23 They serve as large-scale health system
Children's Hospital Association Quality Transformation Network
The Quality Transformation Network (QTN), managed by the Children's Hospital Association for its member hospitals, is the largest quality improvement network in pediatrics.25 QTN conducts coordinated quality improvement collaboratives for high-impact pediatric topics. Initial efforts focused on preventing central line associated blood stream infections (CLABSIs) by standardizing practices related to line insertion and maintenance. In 29 pediatric intensive care units participating in these
Conclusion
Pediatric collaborative improvement networks apply scientific methods (including system science, quality improvement methodology, and qualitative research) and a structured approach to the design, development, and experimental testing of innovations in care delivery. They use collaboration and share data, ultimately standardizing practice. Therefore, variation in outcomes due to unreliable and unnecessary care delivery is reduced, increasing statistical power and allowing a stable system from
Acknowledgments
Dr Lannon receives partial support from the pediatric Center for Education and Research on Therapeutics, supported by cooperative agreement U19HS021114 from the Agency for Healthcare Research and Quality.
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The views expressed in this report are those of the authors and do not necessarily represent those of the US Department of Health and Human Services, the Agency for Healthcare Research and Quality or the American Board of Pediatrics Foundation.
The authors declare that they have no conflict of interest.
Publication of this article was supported by the Agency for Healthcare Research and Quality and the American Board of Pediatrics Foundation.