At our hospitals, “safety first” is a promise

At Children’s Minnesota, we do everything we can to keep children safe and healthy during their hospital visits. We measure the quality of our hospital care and safety in wide variety of ways.  Take a look at our recent measurements below.

Mortality (actual-to-predicted ratio)

While we do our best to deliver miracles, some children are too ill to survive. We track how we are doing at saving lives through the “mortality ratio.” This ratio compares how many patients died at Children’s Minnesota (actual deaths) to the number of patients we expected would die given how sick they were when they came to Children’s Minnesota (predicted deaths). The good news is that fewer patients die at our hospital than we would expect based on the severity of their illnesses.

Actual-to-predicted mortality ratio

When reading this chart, lower is better. 

Data source: Children’s Hospital Association

How we’re improving

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

Length of stay (actual-to-predicted ratio)

Nobody likes to stay in the hospital longer than necessary. So, at Children’s Minnesota we try to help kids get better and get home as soon as possible without sacrificing outcomes or care. The length-of-stay ratio compares how long a patient stays in the hospital (actual time) to how long we thought they would stay given how sick they were when they came to Children’s Minnesota (predicted time).

A ratio of less than 1.0 means a patient was ready to go home sooner than we expected. Children’s Minnesota performs better than other pediatric hospitals on this outcome.

Actual-to-predicted length of stay ratio

When reading this chart, lower is better.

Data source: Children’s Hospital Association

How we’re improving

We start planning for children to go home as soon as they’re admitted. That includes teaching families how to care for their children at home, give medications, and arrange for home care if needed.

Re-admissions

By measuring how many children are readmitted to the hospital, we can learn more about the quality of hospital care and the transition from hospital to at-home care.

Percent of patients who experience seven day re-admissions

When reading this chart, lower is better.

Data source: Children’s Hospital Association

How we’re improving

Children’s Minnesota has implemented a best practice-based, case-management model that helps clinicians prepare patients to go home. If a readmission may have been preventable, the child’s physicians and care team are given recommendations for prevention in the future.

Adverse health events

Adverse health events are serious medical errors that can be prevented. All Minnesota hospitals report serious adverse health events to the Minnesota department of health.

Minnesota state reportable adverse health events

When reading this chart, lower is better.

Data source: Internal safety learnings reports

How we’re 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.

Medication errors that harmed a patient

A “medication error” happens when there is a difference between the drug the doctor ordered and the drug a child received. We only count errors that caused harm — such as increasing the child’s heart rate or needing a monitor to make sure the child is ok.

Adverse drug events that harmed a patient (per 1,000 patient days)

When reading this chart, lower is better.

Data source: Internal safety learnings reports

How we’re 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 tells the nurse something is wrong. We are also helping pharmacists collaborate with doctors to make sure that drugs prescribed in the hospital are consistent with medications given at home.

Central line associated bloodstream infections

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.

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).  Our ultimate goal is to have zero CLABSIs.

Central line associated bloodstream infections (per 1,000 central line days)

When reading this chart, lower is better.

Data source: Children’s Infection Prevention and Control Surveillance Data
Other Pediatric Hospitals comparison source: Children’s Hospitals’ Solutions for Patient Safety Network

How we’re improving

Children’s Minnesota participates in two national collaborative projects with other children’s hospitals to share best practices around preventing these infections. Nurses and doctors follow standard care bundles when inserting the central line and caring for the line after it is inserted. They also wash their hands before they use an IV to give a medicine.