Quality Transformation Network

Palmetto Health Children's Hospital has joined the largest quality improvement network in pediatrics — the Quality Transformation Network, created by the National Association of Children's Hospitals and Related Institutions (NACHRI). Currently, Palmetto Health Children's Hospital is the only South Carolina hospital enrolled in the network.

The multi-year NACHRI initiative is focused on preventing central line associated blood stream infections (CLABSIs) in the nation's pediatric intensive care units (PICUs).

"These types of infections are known to be potentially fatal in hospitals around the world," says Elizabeth Mack, M.D, pediatric intensivist and Director of Quality for Palmetto Health Children's Hospital.

 According to the Centers for Disease Control and Prevention (CDC), Americans get an estimated 1.7 million healthcare-associated infections in the United States each year. "We know that many of these infections are preventable and we know that with proven strategies to prevent them, we can reduce hospital acquired infections," says Dr. Mack.

"Children's Hospital was early to adopt this concept," says Dr. Mack. "We employ infection prevention practitioners to implement procedures that help reduce infection rates. Prevention involves getting everyone from the nurses at the bedside to the patients' families invested in preventing infections," she says.

In her role as physician leader of the program, Dr. Mack has been charged with examining every piece of the puzzle in an effort to get Children's Hospital's quality initiatives aligned under one umbrella. "We want to make our dollars stretch farther while we improve quality and reduce the risk of infections," she says.

"Children with cancer and blood disorders live with central lines — and the risk of infection — every day. CLABSIs cost (on average) $35,000 per occurrence and have a 15 percent mortality rate. So, we must do our utmost to prevent them, especially for our patients who have compromised immune systems," says Dr. Mack.

As part of her strategy to get everyone at Children's Hospital invested in CLABSI prevention, Dr. Mack has created a 'PICU Dashboard' to provide current information about how many infection-free days the hospital has had since the last infection. "We want everyone on staff to know our numbers. We also will be submitting all of our data regarding central line insertion and maintenance to NACHRI."

"Sustaining our improvement requires extensive ongoing monitoring," says Dr. Mack. "We're constantly looking at ways to intervene, assess efficacy and adjust our efforts. All steps are evaluated. Instead of looking at this from management down, we are focused on getting everyone from Environmental Services to Child Life staff, nurses and families engaged."

Dr. Mack meets monthly with a team of physicians, nurses, pediatric pharmacists, Child Life Specialists, infection preventionists and others to focus and fine-tune the strategies and adapt them to Children's Hospital. "It is critical that we commit the resources necessary to implement and monitor our prevention efforts and to continuously measure and report our progress system-wide," says Dr. Mack.

"We're asking a lot from each member of the Children's Hospital staff. We recognize that there is significant daily effort required. We also know that these evidence-based prevention practices will lead to a reduction in CLASBIs — saving money and saving lives," says Dr. Mack.