New findings on patient safety at children's hospitals

ANN ARBOR, Mich. -- In recent years, children's hospitals have joined in the national push to improve patient safety and avoid preventable problems. But it has been hard to measure progress, because of uncertainty about whether standard patient safety measurement tools apply to their patients, who are younger, smaller and on average sicker than those at other hospitals.

But now, a new study of data from 67 children's hospitals in 31 states shows that many of the same indicators used in adult hospitals can be used to measure preventable complications and problems in children's hospital patients, from post-procedure infections and dangerous blood clots to bedsores.

The measurement tools, from the federal Agency for Healthcare Research and Quality, are formally called AHRQ Patient Safety Indicators, or PSIs.

However, the researchers find that two of the AHRQ PSIs are inaccurate for measuring children's care. And they say that none of the measures should be used to compare children's hospitals with one another, though the indicators can be useful in pinpointing individual patients' charts that need to be reviewed.

The study, published in the January issue of the journal Pediatrics, evaluated information about 1.92 million children's hospital stays over four years, compiled by the National Association of Children's Hospitals and Related Institutions, or NACHRI. The team was led by a University of Michigan Medical School faculty member.

The analysis shows that children's hospitals could do a better job in areas such as preventing hospital-acquired infections, clots in intravenous lines and bedsores. These three potentially avoidable problems affected 3.5, 5.7 and 17 patients, respectively, out of every 1,000 applicable children treated at the hospitals in the study. The numbers are risk-adjusted to take into account patient characteristics.

In two other categories, the analysis appeared to reveal a disturbingly high prevent

Contact: Kara Gavin
University of Michigan Health System

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