Center for Health Care Quality Established To Improve Care for People Around the World

Wednesday, March 29, 2006

CINCINNATI -- A new center for quality improvement in health care established at Cincinnati Children's Hospital Medical Center will be a resource for health care providers throughout the world to make the highest-quality care a reality for children and their families.

The Center for Health Care Quality is the result of a merger of the Center for Children's Healthcare Improvement, formerly based at the University of North Carolina at Chapel Hill, and the Center for Health Policy and Clinical Effectiveness at Cincinnati Children's, which not only does improvement work but also conducts research into interventions that improve health outcomes in the community and the home.

"The Center for Health Care Quality will propel us toward our mission of achieving the best medical and quality of life outcomes, experiences and value for patients and families from our community, the nation and around the world," says Tom Boat, MD, chairman of pediatrics and director of the Cincinnati Children's Research Foundation. "The center will enable Cincinnati Children's to link its basic and translational research directly to research that demonstrates better ways to deliver patient care. One immediate result will be the creation of a critical mass of faculty with expertise and training in health care quality improvement research."

The center will collaborate with the American Board of Pediatrics (ABP) -- the certifying organization for general pediatricians and pediatric specialists. The ABP has become increasingly involved in quality improvement efforts throughout the United States and has worked on many projects with the Center for Children's Healthcare Improvement and Cincinnati Children's. Although the new center will be based in Cincinnati, it will have an office in Chapel Hill, adjacent to the ABP.

The Center for Health Care Quality will:

• Support projects to transform health care delivery systems in Cincinnati, the nation and the world.
• Provide education in quality improvement methods and advanced experimental design to create a cadre of health professionals, students and faculty capable of advancing the field of quality improvement in medicine.
• Undertake research that integrates quality improvement methods with clinical and public health research to translate new knowledge into medical practice more rapidly and to design and test novel approaches to health care delivery.
• Work in partnership with other professional and quality improvement organizations to integrate quality improvement methods into the daily work of health care professionals.

Uma Kotagal, MD, director of Health Policy and Clinical Effectiveness at Cincinnati Children's, will direct quality improvement activities; Peter Margolis, MD, PhD, will direct research activities; and Carole Lannon, MD, MPH, will direct education and policy activities. Drs. Margolis and Lannon were previously with the Center for Children's Healthcare Improvement.

"While we have made great strides in improving systems of care through the Pursuing Perfection efforts, the need to build evidence for the role of improvement is critical," says Dr. Kotagal. "I see the center as being able to accelerate improvement efforts and integrate them into the research mission of the organization. With the new center, Cincinnati Children's is positioned to link its investments in basic and translational research to the capacity to design innovative approaches locally and spread what works across the health care system."

The Center for Children's Healthcare Improvement had been nationally recognized for the impact of its work on systems of health care delivery for children and families. The center had a track record of successful multi-organizational collaborative improvement and research efforts. Since 1995, the center worked with more than 1,000 practices, health systems, communities, professional organizations and states across the country to improve care for children with asthma, ADHD, cystic fibrosis and special health care needs, and to support improvements in the preventive services and developmental assessment of children.

Projects with which the Center for Children's Healthcare Improvement had been involved and now brings to the new Center for Health Care Quality include:

• A project with the American Board of Medical Subspecialties to design and develop a web-based patient safety education and quality improvement module that will enable certified physicians in all specialties to learn essential knowledge, skills and attitudes about safety and apply them to improve care.
• A project in collaboration with the American Academy of Pediatrics to assist AAP chapters in improving care for children with ADHD.
• A project with RAND and public health departments to explore how to use quality improvement methods to improve preparedness for a potential pandemic influenza outbreak.

"The Center for Children's Healthcare Improvement had emphasized building capacity in our partners for the work of quality improvement," says Dr. Lannon. "We look forward to continuing and expanding these many collaborative efforts. We're very pleased about joining Cincinnati Children's as we believe this merger brings together experience and expertise that will transform care for children and families, advance the field of improvement science and expand the capacity to improve pediatric care."

Since adopting a vision statement in 1996 of being the leader in improving child health, Cincinnati Children's has invested heavily in quality improvement. In 2001, Cincinnati Children's was the only pediatric institution and only academic medical center in the nation selected for the Pursuing Perfection initiative. Since then, the scope of improvement work has widened and deepened, with 18 strategic quality improvement teams working to improve the entire continuum of care.

For example, the proportion of inpatients with five common conditions receiving evidence-based care has risen from 40 percent to nearly 100 percent. Rates of hospitalization have declined nearly 40 percent for three conditions and 60 percent for another. Gaps in outcomes between Medicaid and privately insured patients have been significantly narrowed for children with juvenile rheumatoid arthritis and cystic fibrosis.

Patient safety, too, has improved. Ventilator-acquired pneumonia, for example, the leading cause of death and illness in adult intensive-care units, has dropped to zero in the Cincinnati Children's pediatric intensive care unit. And, virtually all preventable codes called outside the intensive care unit have been eliminated. These factors not only have improved outcomes but also have helped reduce costs and length of stay.

"Cincinnati Children's has led the way in developing effective models for children's health care delivery," says Dr. Margolis. "It is well on its way to transforming health care at a single academic site. Cincinnati Children's must serve not only as a model for the transformation of care but also create the research collaborations necessary to develop new knowledge about how to apply quality improvement methods as a tool to improve children's health outcomes."

"We're delighted to partner with organizations such as the Center for Health Care Quality that help us develop standards and policies that improve the quality of care physicians provide," adds Paul V. Miles, MD, vice president for quality with the ABP. "We're excited about the new center because it creates a stronger resource and strategic collaborator for the ABP and other national groups focusing on improving pediatric care."

Cincinnati Children's is a 423-bed institution devoted to bringing the world the joy of healthier kids. Cincinnati Children's is dedicated to transforming the way health care is delivered by providing care that is timely, efficient, effective, family-centered, equitable and safe. It ranks third nationally among all pediatric centers in research grants from the National Institutes of Health. The Cincinnati Children's vision is to be the leader in improving child health.