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 six “quality measures” outlined by the Institute of Medicine. These categories are seen as a good way to compare facilities.

Achieving the best possible outcomes


effective

"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 »


Mortality

Actual to Predicted Mortality Ratio

outcomes star

Our hospital

.69

Oct-Dec
2012

.62

Jan-Mar
2013

.57

Apr-Jun

2013

.69

Jul-Sep

2013

 outcomes table line

41 other
children's
hospitals

.83

Oct-Dec
2012

.76

Jan-Mar
2013

.74

Apr-Jun

2013

.74

Jul-Sep

2013

Evaluating this chart: Lower is better.

We never want to see a child die, but sometimes, their illness is simply too advanced to treat. 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.

How we are improving: We review every death to see if we could given more effective care to the child. We examine our past experience and improve our care with every child we treat. Data Source: Pediatric Health Information System database sponsored by Child Health Corporation of America

Benchmark Data: Average of 41 other children's hospitals. The other children's hospitals ratio is less than 1.0 because the expected number of deaths comes from a larger, reference database. Click here for more details.


Readmission

Readmission for Any Condition within 7 Days
(by % of pateints)

outcomes star

Our hospital

4.0%

Oct-Dec
2012

1.6%

Jan-Mar
2013

3.6%

Apr-Jun
2013

4.1%

Jul-Sep
2013
 outcomes table line

24 other
children's
hospitals

4.2%

Oct-Dec
2012

2.1%

Jan-Mar
2013

4.3%

Apr-Jun
2013

4.8%

Jul-sep

2013

Evaluating this chart: Lower is better. Goal of <4.7%

When a child is in the hospital, we want to make sure we treat their problem, get them better, and send them home with the information their family and primary doctor need to help them keep getting better.    

When a child comes back for the same problem within a week, we review the chart to make sure that our care was appropriate and to find out how we can do better. We continue to improve how we prepare patients and their families to go home. The good news is that fewer kids come back to Children's than to other pediatric hospitals.

How we are improving: We start planning for your child to go home as soon as possible after s/he is admitted. This includes teaching you how to care for your child at home, give medications, and arranging for home care if you need it. We participate in a national project with 32 other children's hospitals to reduce readmissions.

Data Source: Pediatric Health Information System database sponsored by Child Health Corporation of America

Benchmark Data: Average of 25 other children's hospitals.


Asthma Home Management Plan

Complete Asthma Home Management Plan
(by % of patients)

outcomes star

Our hospital

88%

Jul-Sep

2012

89%

Oct-Dec

2012

77%

Jan-Mar
2013

85%

Apr-Jun
2013
 outcomes table line

44 other
children's
hospitals

86%

Jul-Sep

2012

88%

Oct-Dec

2012

87%

Jan-Mar
2013

90%

Apr-Jun
2013

Evaluating this chart: Higher is better. Goal of > 73%

If your child has asthma, we want to give you the tools you need to keep your child healthy and out of the hospital. We track how many asthma patients received information on how to reduce asthma symptoms, and protect against an asthma attack at home.

How we are improving: We added reminders in our electronic medical record for our clinical staff to give you this information. We also include follow-up clinic information on this asthma information sheet so you know who to call for a clinic appointment. We encourage parents to be proactive and use our clinic if you notice your child's symptoms are getting worse, so we can help you treat your child outside of the hospital.

Data Source: National Association of Children's Hospitals and Related Institutions database

Benchmark Data: Average of 44 other children's hospitals.

Using resources wisely


efficient

"We want to express our thanks for your thoroughness, our gratitude for your compassion, and our appreciation for the environment."

Read Lori's full story »


Actual to Predicted Length of Stay Ratio

outcomes star

Our
hospital

.93

Oct-Dec
2012

1.01

Jan-Mar
2012

1.03

Apr-Jun
2013

1.03

Jul-Sep

2013

 outcomes table line

41 other
children's
hospitals

1.03

Oct-Dec
2012

1.11

Jen-Mar
2012

1.10

Apr-Jun
2013

1.09

Jul-sep

2013

Evaluating this chart: Lower is better.

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. 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.

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: Pediatric Health Information System database sponsored by Child Health Corporation of America

Benchmark data: Average of 41 other children's hospitals. The other children's hospitals ratio is greater than 1.0 because the expected length of stay comes from a larger, national database.


Median Length of Stay in the Emergency Room         (in Minutes)

outcomes star

Our
hospital

119

Oct-Dec

2012

118

Jan-Mar

2012

109

Apr-Jun

2013

109

Jul-Sep

2013

 outcomes table line

35 other
children's
hospitals

152

Oct-Dec

2012

150

Jan-Mar

2012

142

Apr-Jun

2013

144

Jul-Sep

2013

Evaluating this chart: Lower is better.

Median Length of Stay in the Emergency Room

We track the average time it takes for a patient to receive treatment from a doctor in the Emergency Room.

How we are improving: We 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: Pediatric Health Information System database sponsored by Child Health Corporation of America

Benchmark data: 35 other children's hospitals submitted length of stay information for all visits to their Emergency Departments.

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 »


Readmission Any Condition

Readmission for Any Condition within 30 Days
Jul-Sep 2013 (% of Patients)

outcomes star

Our
hospital

10.4

White

7.7

Black

9.0

Asian

4.6

American Indian
 outcomes table line
41 other
children's
hospitals

10.9

White

9.4

Black

11.7

Asian

6.1

American Indian

Evaluating this chart: Lower is better.

Readmission to the hospital for any condition (within 30 days) may mean that patients are discharged too soon or didn't get proper follow-up care. There were no significant racial differences. 

How we are improving: We work to make sure that all children, regardless of personal characteristics, receive the best possible care. 

Data Source: Pediatric Health Information System database sponsored by Child Health Corporation of America

Benchmark Data: Average of 41 other children's hospitals.

Honoring patient and family values


patient-family

"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 »


Respect and Dignity

Respect and Dignity - Outpatient Clinics
(% Yes, definitely)

outcomes star

Our hospital

94.5

Oct-Dec

2012

86.5

Jan-Mar

2013

90.7

Apr-Jun

2013

90.2

Jul-Sep

2013

 outcomes table line

Other
children's
hospitals

99.4

Oct-Dec
2012

95.0

Jan0Mar

2013

93.9

Apr-Jun

2013

91.2

Jul-sep

2013

Evaluating this chart: Higher is better. 

We ask our families whether Children's clinic doctors treated their children with respect and dignity. To get this information, we send surveys to parents after a child's clinic visit, to ask about and improve family experiences.  

How we are improving: Our clinic managers follow their scores and share them with staff. We constantly ask for feedback from our Family Advisory Council, which includes parents of Children's patients.

Data Source: NRC Picker Family Survey

Benchmark Data: Top 25% of participating children's hospitals based on the 4 most recent quarters.


Attention to Family Experiences

Attention to Family Experiences/Suggestions- Inpatient
(% Yes, definitely)

outcomes star

Our hospital

79.0

Oct-Dec

2012

70.7

jan-Mar

2013

78.9

Apr-Jun

2013

73.4

Jul-Sep

2013

 outcomes table line

Other
children's
hospitals

89.1

Oct-Dec
2012

88.5

Jan-Mar

2013

88.5

Apr-Jun

2013

88.5

Jul-Sep

2013

Evaluating this chart: Higher is better.

You know your child best. We want to know if you felt nursing staff paid attention to your experiences, and listened to your suggestions for caring for your child.   

How we are improving: Our unit managers follow their scores and share them with staff. We constantly ask for feedback from our Family Advisory Council, which includes parents of Children's patients.

Data Source: NRC Picker Family Survey

Benchmark Data: Top 25% of participating children's hospitals based on the 4 most recent quarters.


Involvement in Care Decisions

Would like more involvement in decisions - Inpatient
(% Yes, definitely)

outcomes star

Our hospital

80.2

Oct-Dec

2012

61.1

Jan-Mar

2013

69.5

Apr-Jun

2013

69.1

Jul-Sep

2013

 outcomes table line

Other
children's
hospitals

81.2

Oct-Dec

2012

80.7

Jan-Mar

2013

80.7

Apr-Jun

2013

80.7

Jul-Sep

2013

Evaluating this chart: Higher is better.

You are a critical part of your child's care team, and doctors and nurses should partner with you in caring for your child. We want to know if you would have liked to be more involved in decisions about your child's care.   

How we are improving: Our unit managers follow their scores and share them with staff. We constantly ask for feedback from our Family Advisory Council, which includes parents of Children's patients.

Data Source: NRC Picker Family Survey

Benchmark Data: Top 25% of participating children's hospitals based on the 4 most recent quarters.

Preventing Complications


safe

"The nurses at Children's saw that my son got the help he needed, and that I received the reassurance I needed."

Read Liam's full story »


Minnesota State Reportable Adverse Health Events

0

GOAL per quarter

2

Jan-Mar

2013

1

Apr-Jun

2013

2

Jul-Sep

 2013

2

Oct-Dec

2013

Evaluating this chart: Lower is better.

Adverse Health Events

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

How we are improving: We participate with a group of 32 other children's hospitals to understand better how we can prevent these events. We also review every event (or close call), identify what led to the problem, and make changes to prevent that problem from happening again. 

Data source: Internal safety/learning reports


Falls with injury

0

GOAL
per month

0

Jan-Mar

2013

0

Apr-Jun

2013

0

Jul-Sep

 2013

0

Oct-Dec

2013

Evaluating this chart: Lower is better.

 

Patient Falls

Although falling is a part of growing up, falls can cause serious injury to a patient.

How we are improving: We protect patients from falls by screening for increased risk. We also use bed side rails, non-skid socks, and nursing attention to keep kids "falls-free." We participate in two national groups to reduce falls in children. 

Data source: Safety Learning Reports


Medication Errors

Adverse Drug Events that Harmed a Patient

0

GOAL
per month

25

Jan-Mar
2013

11

Apr-Jun
2013

21

Jul-Sep

2013

 13

Oct-Dec

2013

Evaluating this chart: Lower is better.

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 at least temporary harm, such as increasing the heart rate or needing a monitor to make sure the child is ok. Overall, we give about 100,000 medications each month. 

How we are improving: We are installing 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, then scans the drug's bar code. Any mismatch causes the scanner to alarm and tell the nurse something is wrong. Installation will be complete in 2013. 

Data source: 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

0.6

Jan-Mer
2013

0.7

Apr-Jun
2013

0.7

Jul-Aug
2013

0.8

Sep-Dec
2013

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

0.0

Jan-Mar
2013

0.0

Apr-Jun
2013

1.9

Jul-Sep
2013

0.0

Oct-Dec
2013

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 ot the heart. Central lines can be very useful for taking care of some children. However, because the IV goes directly to the bloodstream, bacteria (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

Surgical Site Infection -
Ventriculoperitoneal (VP) Shunt

3.2

National
Benchmark

2.2

Oct-Dec

2012

5.5

Jan-Mar

2013

0.0

Apr-Jun

2013

3.9

Jul-Sep

2013

Evaluating this chart: Lower is better.

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).

 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.

Reducing waits and delays


timely

"Thanks to this doctor our son was be diagnosed before he came home. They are all amazing! I cannot imagine what could have happened to our little boy if he was not diagnosed."

Read Sam's full story »


Left Without Being Seen (%)

outcomes star

Our hospital

1.46

Oct-Dec

2012

1.57

Jan-Mar

2013

1.5

Apr-Jun

2013

1.09

Jul-Sep

2013

 outcomes table line

39 other
children's
hospitals

2.18

Oct-Dec

2012

2.05

Jan-Mar

2013

1.83

Apr-Jun

2013

1.07

Jul-Sep

2013

Evaluating this chart: Lower is better.

Left the Emergency Room Without Being Seen

We want to help every patient who comes to our Emergency Departments (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 had to wait too long or did not feel they were getting care fast enough. 

How we are improving: We are part of a group of 39 children's hospitals to reduce wait times and patients who leave without getting care. We also 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 Child Health Corporation of America

Benchmark Data: 39 other children's hospitals submitting ED volumes and patients who left without receiving care.