The Child Health Accountability Initiative (CHA1), a pediatric multi-site collaborative, has a primary objective to design, evaluate, and implement national measures of quality and health outcomes for children. Armed with the vision to improve the health care of America's children, CHAI is focusing its efforts on pain management, medication safety, and patient safety. CHAI is first to apply the adult-based Institute for Heaithcare improvement (till) trigger methodology to the pediatric population to identify adverse drug events (ADEs) and is working to integrate pediatric focused ADE triggers into computerized order entry (CPOE). To further drive a proactive approach to medication error reduction, CHAI has recentty completed development of pediatric specific medication rules sets describing dose standardization and ordering guidelines. These rules sets can be integrated into automation systems as part of a comprehensive CPOE system. Additional efforts are planned to adapt a variety of AHRQ patient safety practices from the """"""""Making Health Care Safer: A Critical Analysis of Patient Safety Practices"""""""" report. These include further work in the realm of medication safety but also include pain management and as well as key patient safety practices prioritized by the hospitals participating in CHAI. Pain management best practices will take the approach of educating family, staff, and patients as to pain expectations; wilt implement and test pharmacological and non-pharmacologic interventions to improve pain; and witt continue to determine how hospitals are assessing pain. Patient safety initiatives witl utilize a focused group approach to identify and implement pediatric applications for five selected areas of AHRQ Patient Safety Best Practices as one approach to rapidly spread research into practice. Additional patient safety rapid-cycle improvement projects are planned based on the AHRQ Patient Safety Practices Report rotated to inter and intra-facitity patient transfer and pain management for patients with acute abdominal pain. Using evidence already in the field, CHAt is requesting AHRQ Partnerships for Quality funding to plan and support the expansion of our medication error reduction program; to identify and collaborate on best practices in pediatric pain management; and to evaluate and specifically implement pediatric applications of AHRQ Patient Safety Best Practices.
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