Quality & Safety

Our goal is to make sure your family’s experience at Children’s Hospital & Medical Center is as safe and comfortable as possible. One of the most important ways we can do this is by following strict quality and safety measures.

We are always dedicated to improving our performance. That’s why we track our progress on safety, clinical excellence, patient experience, case management, team wellbeing, and productivity.

We invite you to see for yourself our dedication to achieving our mission. We also invite you to see how others have evaluated our performance through surveys, awards, and recognition.

“An organizational culture focused on patient safety has been critical to our team’s success.”

—Richard G. Azizkhan, MD, President and Chief Executive Officer, Children’s Hospital & Medical Center

Why Quality & Safety Matter To Your Child

Fast Facts

In 2017, Children’s received an IHI/NPSF Lucian Leape Institute Medtronic Safety Culture & Technology Innovator Award for our implementation of an automated hand hygiene monitoring program. Consistent hand cleaning is essential to infection control in healthcare settings.

What exactly happens when medical centers fail to use quality and safety measures? Unfortunately, some centers have learned the hard way:

  • At a pain relief center in the northeast region of the country, 40 patients developed septic arthritis — a painful joint infection that can lead to permanent damage, if untreated. The infection spread after clinic physicians reused contaminated equipment, and one of the physicians did not wash her hands while treating patients.
  • Nurses at a children’s hospital in the midwest often injured themselves while lifting patients. Even though their patients were not obese, many were over 35 pounds — the recommended weight limit for manual lifting. The hospital noticed that these injuries resulted in a significant amount of work days lost. The absent nurses missed opportunities to have meaningful interactions with patients, and provide the top-notch care that their patients deserved.
  • A teenager on the east coast suffered from severe, recurrent abdominal pain. When many different diagnoses and treatments failed to solve the problem, the young girl’s physicians dismissed her concerns. More than 6 years later, an out-of-town physician took her complaints seriously. The teenager was finally given the correct diagnosis and treatment, finally ending her severe pain.

These stories illustrate why tracking performance matters. They have several things in common: They all resulted in patients not receiving quality care, or having unnecessary prolonged suffering. They all could have been prevented.

The 40 patients in the northeast may not have gotten severe infections had the physician washed her hands. The nurses in the midwest hospital may not have missed long stretches of work. The east coast teenager could have avoided years of pain and suffering, and have a better relationship with the people who could save her life, had she had a better patient experience.

At Children’s, our priority is to make sure situations like these do not occur — and that’s why we developed a set of safety and quality measures that we strive to adhere to every day.

Safety Measures

  • Serious Safety Event

    A serious safety event is a situation in which healthcare providers do not follow best practice protocols, resulting in moderate-to-severe harm or death. For example, if a physician does not follow hand washing protocols, and ends up transmitting a staph infection to a patient, this is a serious safety event.

    To measure serious safety events, we use methods set by the Children’s Hospitals’ Solutions for Patient Safety National Children’s Network (SPS National Children’s Network). These methods involve identifying the total number of serious safety events for a given time period, and then using a specific mathematical formula. We perform calculations every month.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing. In this case, we want our performance to be below the goal, which it usually is:

  • Hand Hygiene

    Hand hygiene is all about keeping our hands clean. It is the best way to prevent the spread of infections within the hospital, and keep patients, families, visitors, and staff safe. All of our staff members are required to wash their hands upon entering and exiting a patient room, and before and after providing care to any patient outside of a room.

    The measurement we use is a percentage of hand hygiene compliance based on observations by unknown observers (similar to the concept of “secret shoppers”).

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

  • Preventable Hospital-Acquired Condition Harm Index

    Hospital-acquired conditions (HAC) are conditions or complications that a patient develops during a hospital stay, which are not present when the patient is admitted. In most cases, HACs are preventable.

    We calculate this data by taking the total number of HACs and dividing that by the number of inpatient census days — the amount of patients in the hospital on a single day.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

  • Central Line-Associated Bloodstream Infection Rate

    A central line is a catheter (tube) that is placed in a large vein in the neck, chest, or groin. It is used to give medications or fluids, or to take a blood sample for testing.

    A central line-associated bloodstream infection (CLABSI) occurs when germs enter the central line and make their way into the bloodstream. It is a serious infection, and can increase the length of a hospital stay and costs of care.

    Fortunately, CLABSI can be prevented through proper catheter insertion techniques and management of the central line.

    We calculate this data by taking the number of CLABSIs per 1,000 catheter line days — the number of days in which a patient has a catheter in place.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

Clinical Excellence

Our clinical excellence measure focuses on mortality rate — the number of deaths during a specific time period. We measure mortality rate based on the number of deaths in patients who have been discharged after receiving care at Children’s. The rate is calculated per every 100 discharged patients.

On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

  • The Patient Experience

    The hospital can be an overwhelming place for patients and their families, so we strive to make the experience at Children’s a comfortable and positive one.

    Patient satisfaction also has medical benefits. Studies on patient satisfaction have shown that patients are more likely to follow medical advice and treatment plans, and have better health outcomes after treatment if they have a positive experience.

    Children’s partners with HealthStream — a company that performs patient surveys by phone —  to conduct a patient satisfaction telephone survey. Any family may be contacted following a hospital stay, outpatient visit, or experience with any of our services. Survey participants are randomly selected. We ask patient families to rate their experience from 0 (worst) to 10 (best). The scores below are based on ratings of 9 or 10.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

  • Follow-Up After Emergencies

    When a child goes to the emergency room, we hope to treat the emergency, discharge them, and see them for outpatient, follow-up care. Our goal is to keep them out of the emergency room or hospital for the same problem, right after receiving emergency care.

    However, we sometimes have to admit patients from the emergency room into inpatient care. There also times when a patient is discharged from the emergency room and returns soon after needing to be admitted to the hospital.

    We measure the number of patients admitted to inpatient care within 3 days of their visit to the emergency room.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

  • Re-admissions And Case Management

    Unplanned re-admissions are when a child is re-admitted to inpatient care or observation status within 7 days of hospital discharge, due to unforeseen circumstances (e.g., bad reaction to post-surgery medication, severe pain at surgical site). Unplanned includes admission types such as “emergency” or “urgent.”

    To calculate, we take the total number of unplanned readmission events within 7 days of discharge from the hospital, divided by the total number of patients discharged from inpatient care or observation.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

  • Team Well-Being

    Keeping our employees safe is just as important as keeping our patients safe. This doesn’t just protect our hospital family — it also means that we retain the best employees, which means our patients get better care.

    We look at employee and job-related injuries that result in lost work days, restricted job duties, or transfer to another job per 100 employees.

    On this graph, the green line represents our goal for this area and the blue line represents how we’re doing:

Memberships And Affiliations

Nebraska Hospital Association

This statewide organization partners with representatives from the healthcare industry, legislators, and citizens to help the state develop strong, healthy communities. The Nebraska Hospital Association is the most trusted, respected, and influential voice in the state for healthcare policy and advocacy. It is a leader in patient safety and a valued resource for information.

Children’s Hospitals’ Solutions for Patient Safety National Children’s Network

The SPS National Children’s Network includes leaders from more than 100 pediatric hospitals with a shared goal of harm reduction. Members share the vision that no child should ever experience serious harm while receiving treatment.

View our awards and recognition

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