-- May Help Set Priority Targets for Patient Safety Efforts --
PHILADELPHIA, June 2 /PRNewswire-USNewswire/ -- A large study of health
records from 38 American children's hospitals has measured adverse events
that most increase length of stay and overall cost. The researchers say
their findings provide useful targets for hospital programs aimed at
preventing harm to young patients.
"Our study offers a framework for physicians, researchers and
administrators to think about pediatric-specific adverse events that are
potentially preventable," said study leader Samir S. Shah, M.D., an
infectious diseases specialist at The Children's Hospital of Philadelphia.
"Among the areas in which children's hospitals can address quality
improvement, it is important to set priorities. This study provides some
guidance."
In a study in the June issue of Pediatrics, the researchers analyzed
information from more than 430,000 discharges from 38 pediatric hospitals
in the United States that participated in the Pediatric Health Information
Systems database in 2006. They searched the database for 12 different
adverse patient safety events, designated pediatric-specific quality
indicators (PDIs) by the federal Agency for Healthcare Research and Quality
(AHRQ). The adverse events included infections and other complications that
occurred as unintended consequences of treatment and hospitalization.
"Our study was the first to use this pediatric-specific tool to screen
for adverse events," said co-author Matthew Kronman, M.D., a hospital-based
specialist in infectious diseases at Children's Hospital. "AHRQ had
previously developed patient-safety indicators for adult patients, but some
of those adverse events in adults, such as hip fractures after a fall in
the hospital, were uncommon in children. Our findings suggest that the
pediatric safety indicators reflect a better understanding of the situation
of children."
The total number of adverse events was 6,656, or approximately 1.5
percent of the sample. Overall, the most frequent adverse events in
hospitalized children were infection due to medical care, respiratory
failure following surgery and postoperative sepsis (an infection in the
bloodstream).
The excess length of hospital stay from PDI events ranged from 2.8 days
for accidental puncture and laceration to 23.5 days for postoperative
sepsis. Excess overall charges ranged from $34,884 for accidental puncture
and laceration to $337,226 for in-hospital mortality after pediatric heart
surgery. Among excess charges, the largest were for laboratory, room and
nursing charges. The researchers adjusted charges to reflect geographical
differences in prices and wages.
"Our findings may help guide physicians and hospital administrators
toward changes in practices where even modest improvements could have a
high impact in patient safety and in more efficient, less costly health
care," said Shah. "For instance, focusing quality improvement efforts on
reducing postoperative sepsis and infection due to medical care could
create large cost savings and reduction in length of hospitalization.
Additional studies should focus on determining specific safety measures and
practices that pediatric hospitals can implement in the most appropriate
areas."
Shah added that such quality improvement programs are all the more
important in light of a recent decision by the federal Centers for Medicare
and Medicaid Services to begin denying payments to hospitals for patients
who develop preventable complications during hospitalization.
Shah's and Kronman's co-authors were Anthony D. Slonim, M.D., Ph.D., of
Carilion Clinic Children's Hospital, Roanoke, Va.; and Matthew Hall, Ph.D.,
of the Child Health Corporation of America, Shawnee Mission, Kans.
About The Children's Hospital of Philadelphia: The Children's Hospital
of Philadelphia was founded in 1855 as the nation's first pediatric
hospital. Through its long-standing commitment to providing exceptional
patient care, training new generations of pediatric healthcare
professionals and pioneering major research initiatives, Children's
Hospital has fostered many discoveries that have benefited children
worldwide. Its pediatric research program is among the largest in the
country, ranking third in National Institutes of Health funding. In
addition, its unique family-centered care and public service programs have
brought the 430-bed hospital recognition as a leading advocate for children
and adolescents. For more information, visit http://www.chop.edu.
Contact: John Ascenzi
Phone: (267) 426-6055
Ascenzi@email.chop.edu
SOURCE The Children's Hospital of Philadelphia
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Related links:
http://www.chop.edu
CONTACT:
John Ascenzi of Children's Hospital of
Philadelphia, +1-267-426-6055, Ascenzi@email.chop.edu
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