Children's on Quality

Hand Hygiene at Nationwide Children’s Hospital

Dr. Rick McClead — Mon, 06 Jun 2011 14:59:07 +0000

In the United States, an estimated 5 percent of patients develop an infection while hospitalized. That is nearly 2 million people infected each year. Although hand washing has long been regarded as the most effective preventative measure, estimates of hand hygiene compliance in the healthcare industry range from 40 to 70 percent. Nationwide Children’s Hospital is different, though. In fact, our audits reveal a sustained compliance rate of over 90 percent with many units exhibiting 100 percent compliance. What’s our secret? Listen in as we talk with Dr. Dennis Cunningham, Medical Director for Epidemiology at Nationwide Children’s Hospital, about how Nationwide Children’s Hospital is leading the industry in hand washing compliance.

Pastoral Care at Nationwide Children’s Hospital

Dr. Rick McClead — Thu, 05 May 2011 15:03:14 +0000

For children and their families, a stay in the hospital can be a very stressful time. Pain, worry and fear of the unknown are often made harder by being away from family and friends. The Pastoral Care Program at Nationwide Children’s Hospital aims to support families and staff going through difficult times and also to rejoice in happy occasions or successes. One unique feature to our program is its multicultural nature. We consider all cultural traditions, personal preferences and values, family situations, social circumstances, lifestyles and religions when advising patients, families and staff and creating services and programs. Our pastoral care staff is trained to address the most sensitive of issues that may take place in a children’s hospital. We recognize the importance of supporting our staff so that we, in turn, can provide the best possible care to our patients and their families. Listen in as the Rev. Susan Kyser, Director of Pastoral Care, joins me in discussing our program.

Effects of mother’s addiction on infants: Neonatal Abstinence Syndrome

Dr. Rick McClead — Fri, 01 Apr 2011 14:49:15 +0000

When a pregnant woman uses addictive drugs (illicit or certain prescription drugs), she puts her baby at risk for a number of problems. Neonatal Abstinence Syndrome (NAS) is a term for a group of problems a baby experiences after birth when withdrawing from exposure to narcotics or other addictive substances such as tobacco. These can be long-term, mental or physical in nature and are always harmful to the development of a child. NAS is on the rise all over the world, including central Ohio. Listen in as we discuss NAS and how Nationwide Children’s Hospital’s neonatal services staff have worked to combat its rise in central Ohio. Joining me are Erin Keels, manager of the neonatal nurse practitioners at Nationwide Children’s Hospital, Jackie Schnieder, a neonatal pharmacist at Nationwide Children’s Hospital and Barry Halpern, MD, a neonatologist and Medical Director for the Nationwide Children’s Hospital Special Care Nursery at Grant Medical Center in Columbus, OH.

Reducing the Frequency of Pediatric Pressure Ulcers

Dr. Rick McClead — Tue, 01 Mar 2011 15:31:18 +0000

A 2002 article regarding the incidence and prevalence of pressure ulcers in children reported from survey data that the incidence of pressure ulcers in children was less than 0.3 percent. In 2011, we know this not to be the case. In fact, hospital-acquired pressure ulcers are on the rise. Perhaps healthcare providers thought pressure ulcers were infrequent simply because we weren’t looking for them. We have made great strides here at Nationwide Children’s Hospital in reducing the frequency of pediatric pressure ulcers. What’s more, we are continuing our efforts to drive that frequency all the way down to zero. Listen in as Nationwide Children’s Hospital’s staff weighs in on this important issue: Michelle Miller, MD, Chief of the Section of Physical Medicine and Rehabilitation, Michelle McKissick, Vice President of Surgical and Critical Care nursing and Leah Keller, Quality Improvement Coordinator and your host, Rick McClead, MD, Medical Director for Quality Improvement Services.

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Hospital-Acquired Infections

Dr. Rick McClead — Thu, 03 Feb 2011 15:42:00 +0000

There used to be a time when a certain amount of hospital-acquired infections were expected and accepted in the healthcare industry. Now, Nationwide Children’s Hospital is taking proactive measures to change that attitude and to prevent and reduce the number of hospital-acquired infections on its campus. And, as these infections decline, Nationwide Children’s is committed to maintaining these improvements through additional initiatives. Dennis Cunningham, MD, Medical Director of Epidemiology and Jodi Vinsel, Program Director of Epidemiology, specifically discuss how Nationwide Children’s Hospital is working to reduce five key infections: catheter-associated blood stream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, surgical site infections and various respiratory infections.

Electronic Medical Records (EMR) – Part 2

Dr. Rick McClead — Fri, 14 Jan 2011 16:14:51 +0000

Our discussion of the electronic medical record continues as we address its advantages and disadvantages. One advantage: Electronic Medical Records increase the accessibility of a patient’s record; a doctor can access a patient’s information from any computer hooked up to the system. This may make for speedier, more accurate treatment. As with any major change, though, it will take time for doctors and staff to transition from an informal paper process to a more formal electronic method of record-keeping. In the long run, EMRs may allow for remote medicine, diagnosis, e-prescribing and other off-site treatment.

Electronic Medical Records (EMR) – Part 1

Dr. Rick McClead — Mon, 27 Dec 2010 21:25:34 +0000

In a time where speed and accessibility are ever-growing priorities for businesses, it’s hard to believe that the healthcare industry has only recently made use of the electronic medical record (EMR). Healthcare has always been about information management, but only recently have hospitals recognized the value of the EMR. Listen in as David Rich, MD, Chief Medical Information Officer at Nationwide Children’s Hospital, Jeff Hoffman, MD and Jim Menke, MD discuss why it’s taken so long for the industry to adopt this new technology and how Nationwide Children’s Hospital is among the top ten percent of hospitals throughout the country leading this transition. Be sure to listen in on part two of this podcast, as we continue our discussion about the advantages and disadvantages of the EMR.

Collaboration, Community Keys to Keep Me Well Program

Dr. Rick McClead — Thu, 11 Nov 2010 15:30:37 +0000

Nationwide Children’s Hospital is taking responsibility for its special health care needs population. How? By utilizing our extensive network, partnerships and resources to provide treatment and prevention services in five focus areas: obesity, prematurity, diabetes, asthma and health supervision. Nationwide Children’s Hospital’s Keep Me Well program is committed to ensuring that children with special health care needs meet their full potential. In this interview, Sean Gleeson, MD, Medical Director of Partners for Kids and Vice President for Community Health and Wellness at Nationwide Children’s Hospital, talks about the importance of a community-based approach to providing children with optimal health supervision. Nationwide Children’s Hospital is providing families, Columbus City Schools and the Health Department tools and information for measuring and handling these health concerns. Gleeson also notes the positive response from physicians and community leaders because this program is “giving people the permission to do the things they’ve always wanted to do.” Pam Carr, Executive Director of Partners for Kids, wraps up the discussion by talking about the bright future of the program and states that there are many conditions, populations and community partners the program can expand to include.

Keep Me Well

Dr. Rick McClead — Tue, 26 Oct 2010 15:16:23 +0000

In their August 25, 2010 commentary in the New England Journal of Medicine, Howard Koh, MD, Assistant Secretary for Health, and Kathleen Sebelius, Secretary of Health and Human Services describe the major components of the Affordable Care Act that was passed by Congress and signed by President Obama this Spring. The overriding theme of the legislation is a “vibrant emphasis on disease prevention” and health promotion. Too many Americans, especially our children, are not reaching their full potential because of preventable conditions like asthma, obesity, diabetes and hypertension. Koh and Sebelius believe that the law reaffirms the principle that “the health of the individual is almost inseparable from the health of the larger community. And the health of each community and territory determines the overall health status of the nation.” Promoting health and well-being is a key value of Nationwide Children’s Hospital. We are focusing on the health of the children of our “larger community” through our Keep Me Well program. In the next two Children’s on Quality podcasts, I interview the leaders of the Keep Me Well program, Pam Carr, Executive Director of Partners for Kids and Sean Gleeson, MD, Medical Director of Partners for Kids and Vice-President for Community Health and Wellness at Nationwide Children’s Hospital.

Wellness Promotion at Nationwide Children’s Hospital

Children’s on Quality

Dr. Rick McClead — Fri, 20 Aug 2010 15:36:33 +0000

There has been an explosion in new technologies that are available at our fingertips. How can these tools help us care for patients at Nationwide Children’s Hospital? And how can healthcare providers take advantage of these technological phenomena to provide better overall medical care? Join me on this edition of Children’s On Quality where we will discuss the possible clinical uses of the new technologies in patient care. My guest experts from Nationwide Children’s Hospital are Kelly Kelleher, MD, a pediatric epidemiologist and Director of the Center for Innovation and Jennifer Dyer, MD, a pediatric endocrinologist.

The Drive to Zero: Reducing Medication Errors at Nationwide Children’s Hospital

Dr. Rick McClead — Wed, 28 Jul 2010 17:51:14 +0000

The processes involved in prescribing, dispensing, administering, and monitoring medications to patients are complex and prone to error. In fact, medication errors are the most common type of medical error, and they are a significant cause of preventable harm. This is especially true for hospitalized children for whom medication errors are about three times more common than in hospitalized adults. At Nationwide Children’s Hospital, we are working hard to reduce medication errors and adverse drug events. Listen to this edition of Children’s on Quality as I interview two of our experts who are leading this quality improvement effort.

Breaking the Language Barrier

Dr. Rick McClead — Mon, 14 Jun 2010 14:09:31 +0000

Failure to communicate is a known cause of serious medical errors. Data from the Joint Commission indicates that communication failures contribute to more than 70% of medical errors. This problem is exaggerated when patient-provider communication is complicated by language barriers, especially among immigrant populations. As many of 25% of the immigrant Asian, Hispanic and Pacific Islanders may not have anyone in the family older than 14 years old who speaks English (A.L. Cohen, et al, 2005). Immigrant children represent the fastest growing segment of the pediatric population in the United States. The staff of Nationwide Children’s Hospital care for hundreds of limited or non-English speaking children and families each year. Join me on this edition of “Children’s on Quality” and learn about the interpreter services at Nationwide Children’s Hospital.

Summertime, and the ‘camping’ is easy… but is it safe?

Dr. Rick McClead — Tue, 11 May 2010 20:21:58 +0000

This summer nearly 11 million children and young adults will head off to summer camp. Most will have a great time, but some may have problems. Sometimes, children have adjustment issues when they go away from home for the first time. Others may experience physical injuries that complicate their camp experience. What do parents need to know about getting their child ready for summer camp? How can they assure their child’s safety? Join me on this edition of Children’s on Quality as I ask these, and other questions to two experts from Nationwide Children’s Hospital: Amy Newmeyer MD, a developmental pediatrician, and Dawn Comstock Ph.D., an injury researcher.

“Having our Babies” – Collaborating to Reduce Preterm Births – Part 2

Dr. Rick McClead — Wed, 05 May 2010 14:41:59 +0000

Ohio perinatal outcomes are not good. The March of Dimes has given Ohio an “F” for our poor performance at reducing the prematurity rate in our state. In part one of this podcast, I introduced the Ohio Better Birth Outcomes (OBBO) initiative. This community-wide collaboration is how Central Ohio is addressing the problem of prematurity in Franklin County. OBBO has 4 components. In part one, I discussed the Central Ohio Scheduled Birth Initiative (COSBI) with Dr. Jay Iams, a maternal-fetal medicine specialist at The Ohio State University. In part two, I interview Dr. Phil Scribano, Dr. Jack Stevens and Dr. Jay Iams regarding the other OBBO components: the Nurse-Family Partnership, Safe Spacing, and the 17-P project (17-hydroxyprogesterone).

View March of Dimes Perinatal Statistics
View the 2009 Ohio Better Birth Outcomes (OBBO) Annual Report

“Having Our Babies” – Collaborating to Reduce Preterm Births

Dr. Rick McClead — Wed, 31 Mar 2010 17:46:11 +0000

In an average week, 2,896 babies are born in Ohio. 385 of these babies are born prematurely. 253 weigh less than three and 1/3 pounds. 23 babies will die before they reach their first birthday. Sadly, the rate of preterm birth in Ohio has increased 21 percent over the last decade. Other birth outcomes are not so good either. In 2008, the March of Dimes issued the first state-by-state Premature Birth Report Card. Ohio got a “D” for a prematurity rate of 13 percent. In 2009, Ohio’s prematurity rate increased to 13.2%, and the March of Dimes issued Ohio an “F”. How can we turn that failing grade around and improve our birth outcomes? Listen in to part one of this special two-part edition of Children’s on Quality as I interview some of the leaders of the Ohio Better Birth Outcomes project.

View March of Dimes Perinatal Statistics »
View the 2009 Ohio Better Birth Outcomes (OBBO) Annual Report »

Growin’, Growin’, Growin’! Nationwide Children’s Keeps a Growin’

Dr. Rick McClead — Thu, 11 Mar 2010 20:51:42 +0000

In the fall of 2008, Nationwide Children’s Hospital broke ground on a new 12-floor main hospital that is scheduled for completion in 2012. This new tower will be 750,000 square feet and will be surrounded by six acres of green space featuring parks and healing garden spaces for patients and families. The new building will open with more than 450 patient rooms that are 40 percent bigger and an emergency/trauma center that is twice as big as the current facility. It will also have a new pediatric intensive care, cardiac intensive care and transplant unit. Learn about the new patient care tower on this edition of Children’s on Quality.

"I feel good…" Happy, Healthy, Healthcare Workers

Dr. Rick McClead — Tue, 02 Mar 2010 21:33:37 +0000

Healthy employees are happy employees, and happy employees make better healthcare workers. That is one goal for the Nationwide Children’s Hospital Employee Wellness Program. More than one-third of large employers in the U.S. have such wellness programs. They are designed to give employees “the information, tools and support they need to take charge of their health.” Advocates of the employee wellness programs claim that they reduce absenteeism, lower employer healthcare costs, and increase productivity. Tune in to the Children’s on Quality and learn about Nationwide Children’s Hospital Employee Wellness program. Listen to how this program has impacted the life of one of our employees.

Movin’ On Up…to the ’4 East’ Side: Emergency Department Wait Times

Dr. Rick McClead — Thu, 11 Feb 2010 15:45:13 +0000

With more than 80,000 visits per year, Nationwide Children’s Hospital has the 2nd busiest pediatric emergency department in the United States. Providing timely medical care to that many kids can be a real challenge. Yet, Nationwide Children’s Hospital has some of the best throughput times of any emergency department in America. What is patient throughput? How long is the typical emergency room wait time? How is it that Nationwide Children’s Hospital does so well? Find the answers to these questions on this edition of Children’s on Quality. My guests are Barbara Abdalla, RN and Kathy Nuss, MD from the Emergency Department at Nationwide Children’s Hospital.

Infant Car Seat Safety: If it’s high up, it’s high risk!

Dr. Rick McClead — Tue, 15 Dec 2009 15:07:55 +0000

When infant car seats are properly positioned in the car, they can save hundreds, if not thousands of lives each year. But when they’re used improperly outside the car, these safety devices can lead to serious injury. When you place your infant in a car seat on a counter or table, or any high surface, you are putting your child at risk for a major fall. Infants can suffer from serious head injury, fractures or even asphyxiation. How should you properly use an infant car seat to prevent these injuries? Listen to Children’s on Quality and learn from the Nationwide Children’s Hospital experts about the safe use of infant car seats. “If it’s high, up it’s high risk.”

Pediatric Asthma: It takes your breath away!

Dr. Rick McClead — Wed, 02 Dec 2009 20:09:32 +0000

Worldwide, over 300 million people suffer from asthma, and many of these are children. Sadly, their numbers are increasing. The consequences of pediatric asthma are significant. These include recurrent hospitalizations, poor quality of life and even death. Proven therapies for managing pediatric asthma exist. Yet, recent reports suggest that these therapies are not widely used. Why is this? How is pediatric asthma different from the chronic inflammatory airway disease seen in adults? What should a parent know about their child’s asthma therapy? In this edition of “Children’s on Quality,” I pose these and other questions to Shahid Sheikh, MD, pediatric pulmonologist and asthma expert at Nationwide Children’s Hospital.