video thumb outcomes Dr. Phil Kibort, Chief Medical Officer & V.P. of Medical Affairs, explains how to evaluate outcomes and what tools and information Children's Hospital can offer. When you are making a decision about where to bring your child for care, you want all the information you can get. You want to know how good a hospital is at treating the specific condition your child is facing. You also want to know how a hospital ranks in terms of keeping your child safe and healthy during his or her stay. These measurements are referred to as “outcomes.”

This page lays out information to help you compare Children’s Hospitals and Clinics of Minnesota with similar hospitals locally and across the country. The categories here represent the three “quality measures” outlined by the Institute for Healthcare Improvement. These categories are seen as a good way to compare facilities.



Serving the needs of all children


equitable

"The moms were surprised to be able to share their experience to another mother in their native language."

Read Pat's full story »


Asthma Patients Well-Controlled

Children's works closely with families of children with life-long conditions to assure they live with minimal interruptions to daily life. One of our most important goals is to eliminate the need for trips to the emergency room or stays in the hospital. This requires us to work with the family at every routine visit to anticipate any potentially serious problem and work to prevent them. This measure tells us how often we provide all of the elements found to reduce the need for emergency asthma care at routine clinic visits.

We have seen a failry steady increase in the number of our patients achieving "well-controlled asthma" status over the past few years.

% of patients with asthma considered well controlled 

outcomes star

Our
hospital

42.8

Apr-Jun

2014

42.0

Jul-Sep

2014

53.1

Oct-Dec

2014

54.0

Jan-Mar

2015

 outcomes table line
Goal

50.6

Apr-Jun

2014

50.6

Jul-Sep

2014

50.6

Oct-Dec

2014

50.6

Jan-Mar

2015

Evaluating this chart: Higher is better.

System-Wide Asthma Graph

How we are improving: Children's keeps physicians apprised of patients who have not yet reached the "well-controlled" status so they have a better sense of where care should be focused. We maintain an asthma registry and employ Asthma Care Coordinators on each campus to ensure patients and their families are clear about necessay treatments and when they need to come back to see their doctors.

Data Source: Chart audits and Minnesota Community measurement (MNCM). 


Optimally Managed Diabetes

Diabetes is another long-lasting condition that Children's actively seeks to manage with minimal trips to the emergency room or stays in the hospital. As we do with asthma patients, Children's monitors how many patients meet the highest number of nationally-determined standards that are designed to reduce the need for emergency or inpatient diabetes care. Physicians are kept aware of the patients that have not yet reached "optimally managed" status so they know where concentrated care and patient/family education efforts should be focused.

% of patients with diabetes considered optimally managed

outcomes star

Our
hospital

19.4

Apr-Jun

2014

23.6

Jul-Sep

2014

30.2

Oct-Dec

2014

31.2 

Jan-Mar

2015

 outcomes table line
Goal

24.2

Apr-Jun

2014

24.2

Jul-Sep

2014

24.2

Oct-Dec

2014

24.2

Jan-Mar

2015

Evaluating this chart: Higher is better.

System-Wide Diabetes Graph

How we are improving: We have improved medical record documentation, developed a checklist to assist clinical personnel in obtaining all needed screening tests, added social services and educator’s services to the Diabetes Clinic. The clinicians receive monthly feedback on their individual patients’ optimally managed status.

Data Source: Chart audits 



Achieving the best possible outcomes


QualityofCare

"To this day I have incredibly fond memories of everyone who had worked to save my life when I was a child (not once but twice within a 10 day period of time)."

Read Wendy's full story »


Actual-to-Predicted Length of Stay

The length-of-stay ratio compares how long a patient stays in the hospital (actual), to how long we thought they would stay given how sick they were when they came to Children's (predicted). A ratio of <1.0 means a patient's stay was shorter than we expected, which means most children can go home sooner than we thought! Children's performs better than other pediatric hospitals on this outcome.

Actual to Predicted Length of Stay Ratio

outcomes star

Our
hospital

0.76

Oct-Dec
2013

0.71

Jan-Mar

2014

0.74

Apr-Jun

2014

0.71

Jul-Sep

2014

 outcomes table line

Other 
Pediatric
Hospitals

0.85

Oct-Dec
2013

0.83

Jan-Mar
2014

0.84

Apr-Jun
2014

0.81

Jul-Sep

2014

Evaluating this chart: Lower is better.

Actual to Predicted LOS Graph

How we are improving: We start planning for your child to go home as soon as possible as s/he is admitted. That includes teaching you how to care for your child at home, give medications, and arrange for home care if needed.

Data source: Children's Hospital Association


Left the Emergency Room Without Being Seen

We want to help every patient who comes to our Emergency Department (EDs). To do that, we need to be able to see each patient quickly and keep wait times short. We track the patients who left before our doctors could see them, because they either had to wait too long or did not feel they were getting care fast enough.

Percent of patients who left the ED without being seen (by % of patients)

outcomes star

Our
hospital

0.84

Oct-Dec

2013

0.91

Jan-Mar

2014

1.36

Apr-Jun

2014

1.99

Jul-Sep

2014

 outcomes table line

Other 
Pediatric
Hospitals

1.35

Oct-Dec

2013

1.2

Jan-Mar

2014

1.88

Apr-Jun

2014

1.63

Jul-Sep

2014

Evaluating this chart: Lower is better.

Left Without Being Seen Graph

How we are improving: We are part of a group of other children's hospitals across the country that work together to reduce wait times in the Emergency Room. We have changed how our EDs see patients by adding a "fast track" for kids who just need antibiotics or stitches, a "middle track", and a "long-term" for kids who need serious treatment and maybe a hospital stay.

Data source: Whole Systems Measure collaborative sponsored by Children's Hospital Association. 


Actual-to-Predicted Mortality Ratio

We track how we are doing at saving lives through the "Mortality Ratio." This compares how many patients died at Children's, to how many we expected would die given how sick they were when they came to Children's. The good news is that fewer patients died at our hospital than we expected based on their illness. We do our best to deliver miracles.

Actual to Predicted Mortality Ratio

outcomes star

Our hospital

.90

Oct-Dec
2013

.80

Jan-Mar

2014

.72

Apr-Jun

2014

.55

Jul-Sep

2014

 outcomes table line

Other 
Pediatric
Hospitals

.84

Oct-Dec
2013

.83

Jan-Mar
2014

.81

Apr-Jun

2014

.82

Jul-Sep

2014

Evaluating this chart: Lower is better.

Actual to Predicted Mortality Ratio Graph

How we are improving: We review every death to see if we could have given more effective care to the child. We examine our past experience and improve our care with every child we treat.  

Data Source: Whole Systems Measure collaborative sponsored by Children's Hospital Association.   


Readmission

Readmissions help us understand more about the quality of hospital care and how well the hospital arranges the transition from inpatient to at-home care. Children's has set a goal of a 5% reduction in unplanned readmissions for 2015

Unplanned 7 Day Readmissions
(by % of patients) - 2014

outcomes star

Our hospital

3.13

Jan-Mar

2014

3.35

Apr-Jun

2014

3.23

Jul-Sep

2014

3.10

Oct-Dec

2014

 outcomes table line

Goal: 5% reduction

3.03

Apr-Jun

2014

3.03

Apr-Jun

2014

3.03

Jul-Dec

2014

3.03

Oct-Dec

2014

Evaluating this chart: Lower is better. 

7-Day Readmission Graph

How we are improving: Children's has implemented a best practice-based case management model of working with clinicians to optimally prepare patients for transfer to home care. We review all unplanned admissions, and have found that there are rarely more than 2-5 per month that may have been preventable. These are forwarded to their attending physicians and care team with recommendations for prevention in the future.

Data Source: Children's Data Warehouse


Adverse Health Events

Adverse health events are serious medical errors that can be prevented. All Minnesota hospitals report serious Adverse Health Events to the state Department of Health.

Minnesota State Reportable Adverse Health Events

0

GOAL per quarter

2

Apr-Jun

2014

0

Jul-Sep

2014

4

Oct-Dec

 2014

0

Jan-Mar

2015

Evaluating this chart: Lower is better.

How we are improving: We participate with a group of other children's hospitals across the country to understand better how we can prevent these events. We also review every event, identify what led to the problem, and make changes to prevent that problem from happening again. 

Data source: Internal Safety Learning Reports. 


Medication Errors that Harmed a Patient

A "medication error" happens when there is a difference between the drug a child receives and what the doctor ordered. We only count errors that caused temporary harm, such as increasing the heart rate or needing a monitor to make sure the child is ok.

Adverse Drug Events that Harmed a Patient

outcomes star

Our hospital

0.51

Apr-Jun
2014

0.53

Jul-Sep
2014

0.58

Oct-Dec

2014

0.45

Jan-Mar

2015

 outcomes table line

Goal 10% reduction

0.62

Apr-Jun
2014

0.62

Jul-Sep

2014

0.62

oct-Dec

2014

0.62

Jan-Mar

2015

Evaluating this chart: Lower is better.

Medication Errors Graph

How we are improving: We have installed a special bar code system that works like the scanners used in grocery stores. The nurse scans the unique bar code on the patient's ID band, and then scans the drug's bar code. Any mismatch causes the scanner to alarm and tell the nurse something is wrong. We are also helping pharmacists work more closely with doctors to make sure that any drugs they prescribe in the hospital are consistent with what has been or will be given at home.

Data source: Internal Safety Learning Reports.


Healthcare Associated Infections

Central Line Associated Bloodstream Infections

Central Line Associated Bloodstream Infections–Pediatric Intensive Care Unit
(per 1,000 Central Line Days)

1.4

National
Benchmark

0.0

Apr-Jun
2014

1.1

Jul-Sep
2014

0.0

Oct-Dec
2014

1.1

Jan-Mar
2015

Evaluating this chart: Lower is better.

Central Line Associated Bloodstream Infections- Neonatal Intensive Care Unit
(per 1,000 Central Line Days)

1.3

National
Benchmark

1.6

Apr-Jun
2014

0.8

Jul-Sep
2014

0.4

Oct-Dec
2014

0.6

Jan-Mar
2015

Evaluating this chart: Lower is better.

In hospitals, we use "intravenous lines" (IVs) to help give medications to sick patients. One type of IV is a "central line", which is a thin tube inserted into a large vein that goes to the heart. Central lines can be very useful for taking care of some children. However, because the IV goes directly to the bloodstream, germs can also enter the bloodstream and cause infection if we don't follow standard procedures when using the line to give medicine. These infections are called "Central Line-Associated Bloodstream Infections" (CLABSIs).  

How we are improving: Nurses and doctors follow a standard "bundle" of methods when inserting the central line, and when caring for the line after it is inserted to make sure it is kept clean. They also wash their hands before they use an IV to give a medicine. Children's also participates in two national projects with other children's hospitals to share best practices to prevent these infections. Our ultimate goal is to have zero CLABSIs. 

Data source: Children's Infection Prevention and Control Surveillance Data.

Benchmark data source: Centers for Disease Control and Prevention National Healthcare Safety Network http://www.cdc.gov/nhsn/


Surgical Site Infection - Ventriculoperitoneal (VP) Shunt

When a child has too much fluid inside the brain ("hydrocephalus"), a doctor can place a plastic tube (called a "Ventriculoperitoneal (VP) Shunt") in the center of the brain. This plastic tube goes under the skin and ends in the child's belly. The tube drains fluid from the brain into the abdomen. However, the plastic tube inside the body or the skin around the incision site can become infected. If an infection develops that appears to be related to the surgical procedure, it is classified as a "Surgical Site Infection" (SSI).

Surgical Site Infection -
Ventriculoperitoneal (VP) Shunt

3.8

Jan-Mar

2013

2.4

Apr-Jun

2014

2.9

Jul-Sep

2014

6.1

Oct-Dec

2014

Evaluating this chart: Lower is better.

How we are improving: We are using a standard "bundle" of methods to follow before and during the procedure. Children's is collaborating with other hospitals across the nation to share methods for how to reduce these infections. 

Data source: Children's Infection Prevention and Control Surveillance Data.

Benchmark data source: Centers for Disease Control and Prevention National Healthcare Safety Network http://www.cdc.gov/nhsn/ Note: This is not a pediatric specific benchmark.



Honoring patient and family values


DSC 0659

"Children's became our 'home'. I can't say enough about the wonderful care she received while there and the incredible support we received as a family."

Read Emily's full story »


Overall Satisfaction with Hospital

Children's strives to provide exceptional care and service to every patient and family. After their visit, we ask our families to rate the overall service we provided on a scale from 1-to-10. This measure tells us the percentage of families who gave us either a 9 or 10 rating.

Overall rating of care (% top box response)

outcomes star

Our hospital

77.8

Jan-Mar

2014

78.2

Apr-Jun

2014

79.0

Jul-Sep

2014

80.0

Oct-Dec

2014

 outcomes table line

Other 
Pediatric
Hospitals

 80

Jan-Mar

2014

80 

Apr-Jun

2014

80 

Jul-Sep

2014

 80

Oct-Dec

2014

Evaluating this chart: Higher is better. 

Overall Rating - Hospital Graph

How we are improving: We track these scores regularly for every unit in the hospital and routinely share the results with staff. We also consult with our Family Advisory Council (made up of parents of past and present Children's patients) for feedback and advice on how to make Children's a more welcoming and satisfying enviroment for all patients and families.

Data Source: NRC Picker Patient Satisfaction Survey. This survey is used by many children's hospitals nationwide, which allows us to compare how we're doing with other similar hospitals across the country.


Willingness to Recommend Hospital

Children's strives to provide exceptional care and service to every patient and family. After their visit with us, we ask our families to tell us how willing they would be to recommend our hospital to their friends and families on a scal from 1-to-5. This measure tells us the percentage of families who gave only the highest level of recommendation (a "5" rating). 

Willingness to recommend (% top box response)

outcomes star

Our hospital

85.1

Jan-Mar

2014

77.5

Apr-Jun

2014

84.7

Jul-Sep

2014

85.0

Oct-Dec

2014

 outcomes table line

Other 
Pediatric
Hospitals

 88

Jan-Mar
2014

 88

Apr-Jun

2014

88 

Jul-Sep

2014

 88

Oct-Dec

2014

Evaluating this chart: Higher is better. 

Willingness to Recommend - Hospital Graph

How we are improving: We track these scores regularly for every unit in the hospital and routinely share the results with staff. We also consult with our Family Advisory Council (made up of parents of past and present Children's patients) for feedback and advice on how to make Children's a more welcoming and satisfying enviroment for all patients and families.

Data Source: NRC Picker Patient Satisfaction Survey. This survey is used by many children's hospitals nationwide, which allows us to compare how we're doing with other similar hospitals across the country.


Overall Satisfaction with Clinics

Children's strives to provide exceptional care and service to every patient and family. After their visit with us, we ask our families to rate the overall service we provided on a scale from 1-to-10. This measure tells us the percentage of families who gave us either a 9 or 10 rating.

Overall rating of care (% top box response)

outcomes star

Our hospital

78.8

Jan-Mar

2014

77.5

Apr-Jun

2014

79.1

Jul-Sep

2014

79.1

Oct-Dec

2014

 outcomes table line

Other 
Pediatric 
Hospitals

82 

Jan-Mar

2014

82 

Apr-Jun

2014

 82

Jul-Sep

2014

82 

Oct-Dec

2014

Evaluating this chart: Higher is better. 

Overall Rating - Ambulatory Graph

How we are improving: We track these scores regularly for every unit in the hospital and routinely share the results with staff. We also consult with our Family Advisory Council (made up of parents of past and present Children's patients) for feedback and advice on how to make our clinics a more welcoming and satisfying enviroment for all patients and families.

Data Source: NRC Picker Patient Satisfaction Survey. This survey is used by many children's hospitals nationwide, which allows us to compare how we're doing with other similar hospitals across the country.


Willingness to Recommend Clinics

Children's strives to provide exeptional care and service to every patient and family. After their visit with us, we ask our families to tell us how willing they would be to recommend their outpatient provider to their friends and families on a scale from 1-5. This measure tells us the percentage of families who gave the highest level of recommendation (a "5" rating).

Willingness to recommend (% top box response)

outcomes star

Our hospital

89.1

Jan-Mar

2014

89.2

Apr-Jun

2014

88.9

Jul-Sep

2014

89.6

Oct-Dec

2014

 outcomes table line

Other 
Pediatric
Hospitals

92 

Jan-Mar

2014

92 

Apr-Jun

2014

92 

Jul-Sep

2014

 92

Oct-Dec

2014

Evaluating this chart: Higher is better.

Willingness to Recommend - Ambulatory Graph

How we are improving: We track these scores regularly for all of our clinics and routinely share the results with physicians and staff. We also consult with our Family Advisory Council (made up of parents of past and present Children's patients) for feedback and advice on how to make our clinics a more welcoming and satisfying enviroment for all patients and families.

Data Source: NRC Picker Patient Satisfaction Survey. This survey is used by many children's hospitals nationwide, which allows us to compare how we're doing with other similar hospitals across the country.