CHOC’s Commitment to Quality and Safety: An Update from the Chief Quality and Patient Safety Officer

By Dr. James Cappon

At CHOC Children’s, we’ve worked hard to build a culture of safety, quality and collaboration. We’re proud to have cultivated an environment that not only prioritizes safety, but also emphasizes sharing and openness so that we can all learn from best practices, as well as mistakes or near misses.

So, when a leading safety organizes recognizes CHOC’s commitment to quality, it’s icing on the cake. We are thrilled to be the first pediatric facility in the world to be named a five-star hospital by the Patient Safety Movement Foundation (PSMF).

Dr. James Cappon, CHOC Children’s chief quality and patient safety officer

To reach this achievement, we’ve made formal commitments to all PSMF Actionable Patient Safety Solutions (APSS) – processes designed to eliminate preventable deaths – that are relevant to pediatric care.

Our collaboration with PSMF reinforces the natural tendencies within pediatric care to collaborate broadly, share readily and move quickly in evidence-based ways to constantly learn, teach and make all efforts to avoid patient harm.

Checklists remain key

All of this translates into CHOC’s belief in using checklists. Checklists work, as other industries know well. The concept of the PSMF’s APSS work. In an increasingly complex world, we just need to do the simple, proven things that lead us to our desired outcomes. And our patients and families thank us for our attention to small detail, which reaps big benefit.

We are active partners in a number of regional, state and national networks of children’s providers, patient safety organizations and specialty areas of excellence such as nursing, trauma, extracorporeal life support, and patient and employee experience – all of whom have some compendium of best practice standards.

That’s a good catch

In addition to collaborating and sharing information with our outside partners, we’re doing the same within the walls of our own campus. To move the needle on safety and quality, we all need to be open to learning, course correcting, and sharing. Our “Good Catch” program at CHOC is a great example of that.

This effort is designed to encourage employees to keep their eyes open and speak up when they notice something that could have gone wrong – without fear of punishment or retaliation. Under the program, employees who report a near miss or close call that could have harmed a patient, family member, colleague or visitor are entered into a raffle for prizes each month.

One person who submits a Great Catch – a near miss that could have harmed someone and led to a significant process improvement effort – earns a bigger prize each month.

Investing in quality, safety

We know the small investments in incentives for this program will pay off in dividends when it comes to continuing to cultivate an open and honest dialog around safety and quality at CHOC.

We believe in the power of stories and the importance of individual events, not just rates. This helps us see the impact of single instance and is consistent with our patient- and family-centered model of care.

 

CHOC1 Helicopter Marks 200th Flight

Marking the launch of a new era for emergency transport services at CHOC Children’s, the “CHOC1” helicopter landed for the first time atop the Bill Holmes Tower at CHOC Children’s Hospital earlier this year.

In just 10 months, CHOC1 has clocked 200 flights, traveling all over Southern California, even as far north as Bakersfield, to transports critically ill patients to CHOC. On a typical afternoon, CHOC1 can fly to CHOC Children’s at Mission Hospital in a mere seven minutes, as opposed to driving for one hour in bumper-to-bumper traffic on the freeways.

The transport team is comprised of expert physicians, nurses and respiratory therapists. At the helm is Kevin Barber, lead pilot.

Throughout his 15-year career as a pilot, Kevin has flown many different types of aircraft on a variety of assignments, but he’s found the mission of flying children to be the most rewarding of his career. Prior to flying in the private sector, Kevin was a naval officer for seven years and holds a master’s degree in public administration.

“Aviation offers many different avenues but only being an emergency medical services pilot offers the ability to make a difference in your own community and help people on what is one of the worst days of their lives,” Kevin says. “Plus, the transport teams on our aircraft are top notch. There is a great amount of satisfaction flying with such professional physicians, nurses, respiratory therapists and paramedics.”

CHOC1’s lead pilot Kevin Barber

According to service partner Mercy Air, CHOC1 is the only helicopter in Southern California based out of a hospital, with four pilots and mechanics housed on site at CHOC, giving the transport team the ability to jump into action immediately.

State-of-the-art equipment on board

The helicopter is specially configured with high-tech equipment including neonatal isolettes and smart IV pumps that are loaded through the back of the aircraft and secured into a confined space.

One device in the helicopter is designed to cool critically ill newborn infants.

“To help reduce chances of neurological impairment in these sick newborn babies, cooling needs to be initiated within six hours of birth, or even earlier for better outcomes,” says Tari Dedick, manager of emergency transport services. “If we pick up a critically ill baby in the Inland Empire, we can begin cooling immediately at the bedside and continue the therapy in the helicopter on the way back to CHOC, saving precious time.”

Safety is the No. 1 priority for CHOC’s transport team.

Mercy Air maintains its Commission on Accreditation of Medical Transport Systems accreditation, which has stringent requirements about staff training, medical equipment and even what the CHOC transport team wears, including flight suits and helmets.

Among Kevin’s vast responsibilities as pilot is to closely track weight and balance restrictions. It’s often a tight squeeze in the helicopter, with every person and each device weighed prior to the flight to determine precise weight and balance.

Widening reach

CHOC’s transport team, using ground and air transportation, travels 100,000 miles each year to bring more than 4,000 patients to CHOC. Looking to the future, Tari says, the transport team anticipates eventually transporting trauma patients from all over Southern California to CHOC’s Level II pediatric trauma center.

“Without a doubt, CHOC1 is widening our outreach while bringing the Southern California community closer,” Tari says.

 

Premier CHOC leukemia and immunotherapy conference draws international experts

A premier CHOC Children’s symposium centered around the complex issues facing pediatric leukemia patients drew more than 150 international leaders in the field of children’s leukemia treatment and research. This two-day conference had 33 speakers from various renowned institutions.

Building on the scientific foundation and exchange of information established in the gathering’s five-year history, attendees of the 2018 Society of Young Adult Oncology (SAYAO)/CHOC Children’s Leukemia Symposium shared the latest scientific and clinical advances in acute leukemia, specifically immunotherapy.

CHOC Children’s physician Dr. Van T. Huynh, chaired the symposium and presented her research on asparaginase therapy and silent inactivation.

Titled “From Pediatric to Adult Acute Lymphoblastic Leukemia – The Age of Cellular Therapy,” the Nov. 5 and 6 symposia focused largely on CAR-T cell therapy and new agents for the treatment of acute leukemia. Specific topics included:

  • an update on CAR-T cell products and trials;
  • the future of CD 19, CD22 and NK CAR cell trials;
  • the economics of CAR-T cell therapy;
  • update on leukemia therapy for pediatrics and adolescent and young adults; and
  • supportive care and oncofertility for the leukemia patient.
The symposium drew more than 150 international pediatric leukemia leaders and 33 speakers from various renowned institutions.

The symposium was chaired by CHOC physician Dr. Van T. Huynh, who also presented her research on asparaginase therapy and silent inactivation. CHOC physician Dr. Carol Lin discussed toxicity and management of asparaginase therapy.

Learn more about referring a patient to the Hyundai Cancer Institute at CHOC Children’s.

CHOC Children’s PICU Earns Gold Beacon Award Recognizing Exceptional Patient Care for Third Time

The American Association of Critical-Care Nurses (AACN) recently conferred a gold-level Beacon Award for Excellence in the pediatric intensive care unit (PICU) at CHOC Children’s Hospital. This is the third time CHOC has earned the gold-level distinction.

The Beacon Award for Excellence recognizes unit caregivers who successfully improve patient outcomes and align practices with AACN’s six Healthy Work Environment Standards. Units that achieve this three-year, three-level award with gold, silver or bronze designations meet national criteria consistent with Magnet Recognition, the Malcolm Baldrige National Quality Award and the National Quality Healthcare Award.

“The Beacon Award for Excellence recognizes caregivers in stellar units whose consistent and systematic approach to evidence-based care optimizes patient outcomes,” explains AACN President, Clareen Wiencek, RN, PhD, ACNP, ACHPN. “Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care.”

CHOC’s PICU earned a gold award, the highest designation, by meeting the following evidence-based Beacon Award for Excellence criteria:

  • leadership structures and systems;
  • appropriate staffing and staff engagement;
  • effective communication, knowledge management, learning and development;
  • evidence-based practice and processes; and
  • outcome measurement.

“This award is further validation of our entire pediatric intensive care team’s dedication to the highest standards of patient safety and care,” says Melanie Patterson, RN, MHA, DNP, vice president, patient care services and chief nursing officer, CHOC Children’s Hospital. “We are entrusted with caring for some of the sickest and most medically fragile patients, and our goal is to deliver the best possible outcomes for them and their families.”

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, Calif., the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN joins together the interests of more than 500,000 acute and critical care nurses and claims more than 235 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. To learn more about AACN, visit www.aacn.org.

Dr. Stanley Galant Recognized by the American Academy of Allergy Asthma & Immunology

Dr. Stanley Galant, medical director of the CHOC Children’s Breathmobile has been recognized by the American Academy of Allergy Asthma & Immunology (AAAAI) with the 2019 AAAAI Outstanding Volunteer Clinical Faculty Award. This award is being presented to Dr. Galant for his outstanding contributions and diligent work in helping to advance knowledge in and treatment of allergic disease; specifically, in recognition of service to the University of California Irvine allergy/immunology training program as a teacher and mentor.

CHOC’s Breathmobile, the only mobile asthma clinic dedicated to serving preschool and school-aged children in Orange County, removes barriers for children and their families who may be unable to travel or pay for preventive asthma care.

Among Dr. Galant’s achievements, in 2017, he received the Robert M. Zweig, M.D., Memorial Award from the South Coast Air Quality Management District (SCAQMD) for his longtime work to help children with asthma in the community.

Dr. Galant will be recognized at an awards luncheon held at the 2019 AAAAI Annual Meeting in San Francisco on February 23.