Standardizing Processes and Care for Pediatric Patients Case Studies

Akron Children’s Hospital was named a 2019 HIMSS Davies Enterprise Award recipient for leveraging the value of health information and technology to improve outcomes as demonstrated in the following healthcare case study overviews. From creating standardized guidelines and utilizing innovative population health tools to creating comprehensive treatment pathways in their EHR, here’s how one healthcare organization successfully innovated to provide better, safer patient care.

Case Studies

1. Reducing Narcotic Prescriptions for Pediatric Post-Operative Patients With Standardized Guidelines at Discharge

With the ongoing opioid epidemic facing the U.S., health systems everywhere are looking to update their prescribing practices in ways that better protect patient safety and improve population health. That’s why this Davies award-winning hospital developed an EMR-based quality initiative aimed at measuring and analyzing physician prescribing practices. The data collected was used to develop new standardized guidelines used for discharging pediatric post-operative patients, with a goal of reducing overall narcotic prescriptions.

2. Utilizing Population Health Information and Technology Tools to Improve Lead Screening Rates

Upon realizing that only 71% of their patients were screened for lead toxicity at one year of age and only 41% at two years of age, Akron Children’s Hospital knew it was essential to integrate state-of-the-art population health tools into their EHR to improve their screening rates. These tools allowed them to improve the overall screening process for lead toxicity and to care for those affected in a timelier manner.

3. Transformative Idiopathic Scoliosis Comprehensive Treatment Pathway

Idiopathic scoliosis is the most common form of spinal deformity. Causing a curve in the spine, it typically occurs between age 10 and when a child is fully grown.

The orthopedic surgery group at Akron Children’s Hospital recognized there was tremendous variation in the preoperative, intraoperative and postoperative care of patients with this form of scoliosis. This was because surgeons were still referencing historical practice preferences of six individual surgeons—and the guidelines were not current or evidence-based. The group needed to update these so they could standardize care and optimize value for patients by providing improved pain control, expediting recovery and decreasing length of stay—all without negatively impacting readmission rates.

To tackle this challenge, the hospital worked to implement a pathway that allowed patients to receive standardized preoperative surgical clearance and optimization, standardized anesthetic management and multimodality pain management, and postoperative admission to a single, specialized regular nursing floor with immediate mobilization, dietary initiation and co-management by the hospitalist service. Order sets—standardized, evidence-based guidelines in the EHR—were created to facilitate compliance with these pathways, including preoperative, anesthesia and pain management, and postoperative inpatient, as well as standardized discharge instructions.

As a result, Akron Children’s Hospital was able to decrease length of stay for idiopathic scoliosis patients by 50%—with no adverse impact on postoperative complications. Patients with idiopathic scoliosis are now cared for on a single floor, with fully utilized order sets standardized to support quality care.

An economic benefit to patients and payers was also achieved, with a 12% decrease in costs. In comparison to the previous year, patient charges were reduced by $16,500, and direct costs for patients decreased $10,300.

Updated March 6, 2020