From re-imagining uses for technology to shaping improvements from the ground up, leaders at children's hospitals are using a variety of approaches to address operational and health care delivery challenges. Here are recaps from four sessions at the 2018 Annual Leadership Conference that show how hospitals are making changes—catch the recordings on demand.
Keeping kids healthy
Leaders at Dayton Children's Hospital started with three key strategic alignment goals to create a clinically integrated network.
- Develop quality and population health work in primary care. The initial outreach identified pediatricians as champions, and they were empowered to make decisions, including where to focus clinical collaborations. Community pediatricians were on committees that vetted network development and structure, quality metrics and technology tools.
- Leverage other population health work through collaboration. Health partners included 12 independent primary care practices, 30 locations and more than 135 specialists.
- Integrate data. Data is an asset, and leaders recognized collecting the correct data and analyzing it takes time to plan and execute. They sought to demonstrate performance for payers and community partners, enable true population health data analysis, and provide additional insights to each provider.
The benefit of nimble project management
Growth requires flexibility and patience. Teams at Ann & Robert H. Lurie Children's Hospital of Chicago used an enterprise project management office (EPMO) model to align resources and improve prioritization and coordination of efforts. Leaders wanted to see organizational improvement, but also simplify the process to manage change.
The hospital formed an EPMO committee that determined the level of support staff needed to accomplish a goal. Working with EPMO also helped clarify the process for improvement by defining an entry point for a project request. Lurie Children's selected parameters for four types of projects to progress through EPMO. Parameters include:
- Capital request over $5,000
- Work will impact other departments
- Requires resources outside of your department
- Senior leader in agreement of the need
While EPMO is not a quick fix for project management, it did help hospital leaders successfully begin to refine the process.
Technology and gaming shapes the future of patient experience
A variety of studies found gaming and extended reality are viable clinical tools. Findings include:
- Using gaming technology linked to decreased distress, increased cooperation and improved pain management
- Children with access to a video game during anesthesia induction were less distressed and more cooperative during mask induction
- Virtual reality distraction was significantly better than standard of care for port access in children
- Augmented reality during pediatric burn dressing changes reduced pain scores compared to standard distraction
However, leaders at Children's Hospital Colorado discovered tech advances also introduce challenges like supporting the platforms necessary for gaming systems, staff impact, maintenance and risk of negative patient or family experience. To help facilitate the gaming initiative, the hospital created the role of gaming technology specialist (GTS). The GTS manages technical needs, industry partnerships and collaborates with Child Life staff in direct care.
3 ways to improve care through telehealth
With pediatric tele-education models, three hospitals improved how they address challenges of delivering care in rural and underserved communities.
Nicklaus Children's Hospital telehealth program gives more students access to registered and advance practice nurses. Leaders had the vision "To Be Where the Children Are." The telehealth program aims to provide basic school health services, care coordination and disease management for 74 schools. Organizers sought to demonstrate that nurses can keep kids in school to learn.
In one year, the majority of complaints the advanced practice registered nurses addressed through telehealth included sore throat and eye irritation. Only 29 percent of the students who used telehealth were sent home; 71 percent of the students seen were sent back to class.
Upstate Golisano Children's Hospital introduced Project ECHO (Extension for Community Healthcare Outcomes). The goal of Project ECHO was to break down gaps between specialty and primary care practices. Leaders also wanted to open access to care for communities with higher proportions of immigrants, ethnic minorities and rural environments. TeleECHO clinics helped share best practices across 17 counties in the hospital's area.
To improve access for behavioral health services, Children's Hospital & Medical Center in Omaha is partnering with Nebraska primary care clinics to provide telepsychiatry. So far the partner clinics have conducted more than 1,600 telepsychiatry visits. The surge in demand has led to expansion to four new sites and the addition of an advanced practice provider.
See you next year
Mark your calendar to join peers for continued networking and learning at the 2019 Annual Leadership Conference Nov. 4-6 in Phoenix.