The Department of Pediatrics is dedicated to improving our practices and processes so we can better serve our patients and community. QI projects can be submitted by faculty members or trainees in the department. The list below is made up of suggested projects submitted before 19 April 2023.
|What is the problem this project aims to solve
|How Conference Cash Improved Conference Attendance
|COM – General Pediatrics
|Trainee attendance at conferences as part of their education curriculum significantly declined secondary to social distancing during the COVID-19 pandemic. With abysmal participation in the education curriculum – despite the shift back to in-person conference – came a significant decrease in our academic center’s pediatric board examination pass rate. An incentive program was implemented to address the decline in conference attendance.
|A Quality Improvement Initiative to Improve the Identification and Diagnosis of Pediatric Hypertension in an Academic Primary Care Setting
|The prevalence of hypertension in children and adolescents is increasing. Adherence to national guidelines for pediatric hypertension screening is low. In this quality improvement project, the team seeks to improve the recognition and documentation of high blood pressure in patients 13 and older who presented to general pediatric clinics.
|Initiative to Improve the Identification and Diagnosis of Pediatric Obesity in an Academic Primary Care Setting
|Provider identification of obesity in children ages 2-10 was 37% in Q2 2023 and it should be at least 95% in primary care. National clinical practice guidelines exist. Hampl SE, Hassink SG, Skinner AC, et al. Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. Pediatrics.
|ED to Hospital Admission Throughput
|Hospital Medicine, EM
|There is a longer-than-peer-average time for admitted pediatric patients to be admitted from the ED to the acute care floors, leading to backup in the ED flow and prolonged wait times, as well as possible delays in care.
|Improving Nursing Presence on Hospitalist Rounds
|Currently, there is wide variation between teams and attendings on nursing presence on bedside rounds on hospitalist patients, with about half of patients meeting this goal on average. We want more patients to have their nurse presence on rounds as this improves communication and safety.
|Medication Alert Optimization
|Medication Safety Committee
|Providers at Arkansas Children’s, including physicians, nurses, and pharmacists, are forced to interact with a large volume of interruptive alerts when ordering or reconciling medications in EPIC. This leads to workflow inefficiency, provider burnout, and the potential for patient harm due to alert fatigue.
|The ACH NICU currently has a current rate of 62% of infants being discharged on some amount of human milk. Human milk is the nutritional gold standard for premature, near-term, and term infants and provides both long- and short-term benefits including reduced incidence of sepsis, reduced necrotizing enterocolitis, reduced chronic lung disease, reduced retinopathy of prematurity, improved neurodevelopmental outcomes, and reduced length of NICU stay and readmissions.
|Detection of Hospital-Acquired Infections in Pediatric Patients Supported on Extracorporeal Membrane Oxygenation
|We hypothesize that inflammatory markers (white blood cell count, c-reactive protein, and procalcitonin) are useful for detecting infections in patients receiving extracorporeal membrane oxygenation (ECMO) and can reduce the frequency of drawing routine cultures.
|Identification and Evaluation of Pediatric Child Abuse by Medical Trainees
|Pediatric Emergency Medicine
|Alexis Antonopoulos, D.O.
|Utilizing the TEN-4-FACES-p rule, this project aims to strengthen Family Medicine resident’s comfortability and knowledge regarding the early recognition of pediatric child abuse for children under the age of 4 years old who may not be captured at a regional children’s hospital. Through a grand rounds lecture and follow-up resource material, Family Medicine residents will acquire sustainable knowledge and confidence surrounding the use of the TEN-4-FACES-p rule to promptly identify and evaluate for pediatric child abuse.
|Pneumococcal Vaccination in Nephrotic Syndrome Quality Improvement
|Immunization is essential in preventing life-threatening infections from the bacteria, pneumococcus, in children with nephrotic syndrome (NS). An additional 23-valent pneumococcal polysaccharide vaccine (PPSV23) series is required for children with NS. Despite current practice guidelines, many children with NS do not receive PPSV23. Yale Children’s Hospital published in 2022 their QI project focusing at improving immunization rates. All interventions were focused at the healthcare team, not the patient. Interventions included provider education of the PPSV23 literature and vaccine guidelines, regular performance reviews at division meetings, creating an immunization protocol, posting performance charts on the office bulletin board, and unifying vaccine recommendation templates and lastly, specific and timely EHR reminders. This resulted in improvement in vaccination rates from 12 to 86%.
|Residency Board Pass Rate
|Board pass rates below the national competition
|Pediatric to Adult Rheumatology Transition Program of Arkansas (PARTnAR)
|Our patients with chronic disease reach the age of 18-21 without having the required skills needed to function in the world of adult medicine. There is no transition plan and patients have gaps in care, no plan for insurance coverage, and have not identified an adult provider. More over their health literacy is not at a level where they can function independently without a family member present. The goal is to provide a seamless transition to adult care with patients being well prepared for the transition.
|Access to Outpatient Surgical Care in a Rural State
|By investigating the impact of the demographics and geographics on potential delays in care, the pediatric surgery group will be able to design interventions on how to improve access to surgical care.
|Poor patient/parent survey results regarding discharge communication, particularly what to do if the child is not getting better after discharge.
|Hyperoxia is common in our PICU. Hyperoxia is associated with worse outcome
|high variability in sedation weaning between providers
|delayed mobility among critically ill patients
|Improve Family Satisfaction Score
|low family engagement survey scores
|Delayed extubation and variable practice in extubation readiness assessment
|High antibiotic utilization
|Effectiveness of Teach Back Method in Improving CPAP Adherence in the Pediatric Population
|increasing overall CPAP adherence in children prescribed PAP therapy – improving patient’s understanding of OSA and health consequences if left untreated