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MassGeneral Hospital for Children is dedicated to providing the highest quality care to every patient. The Quality and Safety Team works to identify and support strengths as well as opportunities for improvement across the hospital.
When you get “outstanding quality” health care, it means your care is based on evidence, family –centered and provided by skilled and knowledgeable professionals who communicate and coordinate the care in a timely way.
You and your child should feel safe at MGHfC, and of the best ways to improve patient safety is to constantly monitor performance and family experiences to set up systems to provide the best care for your child. The MGHfC Quality and Safety is committed to this work every day.
MGHfC, as a national leader in Quality and Safety, is distinguished by a culture that partners with patients and families to assure that care is safe, high quality, equitable, and efficient.
This culture is characterized by:
Peter Greenspan, MD, Vice Chair; Medical Director, MGHfC
Sandra Dodge McGee, MHA, Executive Director, MGHfC and Partners Pediatrics
Esther Israel, MD, Quality Chair, Pediatrics
Cassandra Kelleher, MD, Quality Chair, Pediatric Surgery
Lindsay Carter, MD, Director, Inpatient Quality and Safety
John Co, MD, MPH, Director, Outpatient Quality and Safety
Kristen Solemina, MPH, Quality and Safety Manager
Denise Lozowski, RN, MSN, Quality Nurse Coordinator
Jessica Mascola, BS, Quality and Safety Program Coordinator
Michael Peer, MS, Quality and Safety Data Analyst
The MGHfC Quality and Safety Team work with leadership and staff to provide the highest quality, safest and patient-centered care to our families. We strive to create a culture of continuous improvement through communication, education, information dissemination and data-driven improvement.
Since 2009, our team has implemented safety initiatives and evidence-based care models across all care delivery areas at MGHfC.
Our structure begins with unit-based triads (physician, nurse and administrator), that report into our ambulatory and inpatient quality and safety team to foster shared learning, teamwork and communication. Our work is driven by priorities set by MGHfC leadership, and MGH leadership including Patient Care Services, Practice Improvement and the MGH Center for Quality and Safety.
Strategic Plan, Goal #1. Reinforce the culture of continuous improvement
MassGeneral Hospital for Children (MGHfC) is engaged in a variety of local and national quality improvement (QI) initiatives, impacting children's health care locally and nationally.
Strategic Plan, Goal #2. Improve safety culture
Strategic Plan, Goal #3. Improve patient safety, especially in high risk areas
It can be difficult for infants and children to communicate their concerns or changes in symptoms. MGHfC offers our patients, families and staff a robust patient safety program which focuses on family participation in care, mitigation of safety risks, teamwork and rapid response to emergencies. We are committed to being a high reliability organization where our systems support patient safety and allow our patients, families and staff to feel free to speak up about patient safety concerns.
Some examples of our Patient Safety initiatives include:
Safety Culture – MGHfC is committed to a strong safety culture in which families and staff feel free to raise patient safety concerns and those voiced concerns result in patient safety improvements. We are proud that we have outperformed our peers on the AHRQ (Agency for Healthcare Research and Quality) Safety Culture Survey.
Near Miss Safety Reporting – Staff are encouraged to report near misses which represent opportunities to improve patient safety. Over 1200 reports are filed across pediatrics every year.
Medication Safety – An interdisciplinary medication safety committee, Preventing Pediatric Medication Errors (PPME) Committee, consisting of physicians, nurses, pediatric pharmacists, information systems experts and quality specialists who oversee pediatric medication safety projects.
Rapid Response – MGHfC Neonatal and Pediatric Rapid Response Teams can be activated for any acute or unexpected clinical concerns. The Rapid Response Team comes to the patient location to assist patients and care teams with their urgent concerns.
Good Catch Program – MGHfC recognizes staff who speak up and prevent an error which could have reached a patient.
Integrated Electronic Medical Record – Single electronic medical record across all practices enables all providers to review notes from other provides, test results and medication lists. The patient portal (My Chart) provides patient access to parts o their medical record as well as a secure portal for communicating with their providers.
Family Centered Rounds – Families are encouraged to participate as team members during morning rounds. This enables parents to actively participate in their child’s care planning and provides a time for raising questions or concerns.
Patients and families may receive a phone call or mail survey following their hospitalization or ambulatory visit asking about their experience and anything that we can do better for the family in the future. At MGHfC, we utilize our patient experience survey scores and responses to continually assess the quality of care we provide to our patients and families. Suggestions that families make or improvement opportunities identified allow us to constantly hold ourselves to the highest standards of care for our patients and families.
The MGHfC Quality and Safety team partners with parent volunteers to hosts staff training sessions. These sessions focus on understanding and optimizing the family experience at MGHfC. Staff gain perspective from the parents as well as strategizing improvement opportunities by directly collaborating with families.
“The staff were amazing. The receptionist is amazing. The nurses are brilliant. My kid just loves it there. Anytime he goes there he feels comfortable, and the staff are unbelievable.”
“They delighted me because they are kind of like an extended family to us. They always treat us with respect. They are always just very courteous. It's just a great experience in stressful times, especially.”
“They were very respectful. They kept us informed on the time of wait. They gave us very good information about the procedure, as well as having very good bedside manner.”
“His ability to sit and talk to a child, engage a child, explain what he was doing, and what was happening. He's a wonderful doctor.”
“[The doctor] is a phenomenal medical doctor, surgeon, and caretaker. He had a kind and wonderful bedside manner with my 11-year-old son. He explained the surgery, was reassuring, and confident. [The doctor] was kind to my son. He patiently listened to questions I had and answered each question. He is the best pediatric surgeon in the world.”
“[The doctor] is the best pediatrician I have ever encountered. She is nice, courteous, great with kids, and has excellent medical knowledge. I have the greatest possible confidence in her abilities to care for our children and have recommended her to numerous friends.”
Strategic Plan, Goal #5. Advance provider skills in safety science and quality improvement
Resident Program – The MGH Pediatric Residency program is committed to educating its trainees in the principles of patient safety and quality improvement, as well as meaningfully engaging residents in improvement initiatives for providing experiential learning opportunities as well as ensuring its initiatives are informed by residents.
Psychological Safety Leadership Programs – A four session psychological safety leadership series focused on communication techniques and teamwork.
Partners' Clinical Process Improvement Leadership Program (CPIP) is an intensive 6 – 8 session program with the purpose of engaging clinical teams in the use of process improvement tools to reduce variation in care and improve outcomes for patients.
Team STEPPS – An evidence-based teamwork system to improve communication and teamwork skills among health care professionals.
Patient Safety Awareness Week MGHfC celebrates patient safety accomplishments and educates patients, providers and staff on patient safety. Every year the hospital recognizes a select group of Patient Safety Stars, nominated by their peers, for their commitment to patient safety within the hospital.
Interdisciplinary Tracer Program - A team consisting of nurses, doctors, physician assistants, registered pharmacists and quality and safety specialists visit each unit to evaluate hospital and patient care operations.
Strategic Plan, Goal #6. Establish a national presence through scholarly activity
March 2017 Quality and Safety in Children's Health Conference (poster) “Parents Co-Facilitating Staff Helpfulness Trainings at MassGeneral Hospital for Children”
July 2016 The 7th International Conference on Patient and Family-Centered Care (poster) “Parents Co-Facilitating Staff Helpfulness Trainings at MassGeneral Hospital for Children”
March 2014 Implementing Quality Improvements in Children’s Health Conference (enhanced learning session) “Keeping in Local: Engaging Pediatric Physicians in Quality Improvements”
March 2013 Children’s Hospital Association’s (formerly NACHRI) “Creating Connections” Conference (presentation) “Agreeing On, and Implementing, Clinical Standards across Practice Sites”
July 2012 National Patient Safety Foundation in Washington, D.C. (poster) “Safety Reports - A Vehicle for Change and Improvement at MGHfC”
May 2012 National Patient Safety (poster) “Can Low Volume High Risk Pediatric Medication Safety a Large Academic Medical Center?”
2012 Digestive Disease Week (poster) “Measuring Colonoscopy Quality in Pediatrics – A Quality Improvement Initiative”
March 2009 Creating Connections Conference NACHRI/CHA “Speak Up- Engaging Patients, Families and Staff in Quality and Safety”
- A Pilot Study of Autism-Specific Care Plans During Hospital Admission
- Association Between Allergen Exposure in Inner-City Schools and Asthma Morbidity Among Students
- The Impact of Pediatric-Specific Vancomycin Dosing Guidelines: A Quality Improvement Initiative
- Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning
- Emergency Department Utilization Report to Decrease Visits by Pediatric Gastroenterology Patients
- Cost savings associated with decreased emergency department utilization by reporting emergency department visits to specialists
- Department Utilization Reports to Address Avoidable Visits by Patients followed by Pediatric Specialists – accepted for publication
- Review of quality measures of the most integrated health care settings for children and the need for improved measures: recommendations for initial core measurement set for CHIPRA
- Measuring patient and family experiences of health care for children
- Impact of online education on intern behaviour around joint commission national patient safety goals: A randomized trial
- Pediatric resident education in quality improvement (QI): a national survey
- Providing educational content and context for training the next generation of physicians in quality improvement
- A mixed methods approach to developing and evaluating oncology trainee education around minimization of adverse events and improved patient quality and safety
- Use of spaced education to deliver a curriculum in quality, safety and value of postgraduate medical trainees; trainee satisfaction and knowledge
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