Sample Projects
Increasing Enrollment in the CRETE Trial
The objective of this project is to increase the percentage of enrollment per eligible patients for the CRETE trial from 24% to 45% by November 2024. To achieve this goal, several key drivers have been identified, including enhanced communication during illness, cultivation of a strong research culture at the institution, local medical team buy-in, family willingness to participate, and the availability of staff. Interventions to support these drivers include regular updates and presentations at staff meetings, educating physicians, trainees, APPs, and RNs about the study, team huddles before meeting families, pre-introduction of the research team by the medical team, tips for effective communication during difficult news delivery, scripts for challenging questions during consent, and a roadshow to raise awareness about the CRETE trial.
Incorporating Virtual Reality into Pediatric Sedation
This project aims to enhance patient experience by incorporating virtual reality (VR) into the pediatric sedation service, with the goal of increasing VR use from a baseline of zero to 50% of eligible patients within six months, by March 2025. Key drivers include adequate education for the sedation and child life teams, buy-in from proceduralists and families/patients, and the availability of equipment and software. Proposed interventions involve in-service training for the sedation team, developing a standard evaluation form, educating on procedures done in a seated position using VR, creating workflows for cleaning and storage, and conducting roadshows to discuss the benefits of VR with proceduralist teams.
Reducing Pediatric Delirium in the PCICU
The goal of this project is to reduce the use of antipsychotics in the PCICU by 10% by September 2025, measured as antipsychotic days per patient days. Key drivers for this objective include early identification and monitoring of delirium, optimizing pain management and sedation, reducing environmental stressors to promote sleep, engaging and educating families, and enhancing interdisciplinary care coordination. Interventions aimed at achieving these goals include using standardized delirium screening tools (CAPD) charted every shift, employing non-pharmacologic pain management techniques (such as music therapy and child life interventions), developing protocols for identifying high-risk patients for delirium, creating a sedation protocol that prioritizes non-invasive, low-dose options, educating families about pediatric delirium and encouraging their involvement, and implementing daily multidisciplinary rounds.
Improving Sepsis Outcomes
The objective of this project is to decrease the number of hospital-onset sepsis cases in admitted pediatric patients by 20% by the year 2025. To achieve this, key drivers include addressing culture and unconscious bias, implementing targeted education programs, and optimizing processes for the recognition and treatment of sepsis. Specific interventions include revitalizing the sepsis work committee, launching a system-wide education campaign, updating and rebuilding the sepsis dashboard, initiating sepsis huddles and monitoring compliance, using embedded simulations in all areas, transparently sharing sepsis data at the unit level, conducting interdisciplinary reviews of sepsis case management and outcomes, optimizing antibiotic selection and availability, and engaging patients and families in sepsis prevention and management strategies.
Increased NICU extubation rate
The quality improvement (QI) project aims to increase the percentage of inborn infants, gestational age 24 0/7 to 29 6/7 weeks, who are extubated within the first 7 days of life from 46% to 60% by December 2025. The project's key drivers include optimizing non-invasive respiratory support in the delivery room, ensuring multidisciplinary buy-in, and optimizing caffeine usage. Interventions focus on standardizing extubation processes, providing educational resources like a "Tips and Tricks" pamphlet for TCOM use in infants under 29 weeks, and conducting "Lunch and Learn" sessions on evidence-based practices. Additionally, they aim to standardize approaches to apneas and bradycardia events, implement "A Week to Wean" strategies, and invigorate extubation criteria.
Increasing the rate of non-invasive resipiratory support in the NICU
The quality improvement (QI) project aims to increase the percentage of infants maintained on non-invasive respiratory support during the initial 72 hours after birth from 40% to 60% over two years, targeting inborn infants between 25 and 29 weeks gestational age who receive resuscitation. The primary goal is to reduce long-term morbidities associated with mechanical ventilation in neonates. Key drivers of this improvement include optimizing non-invasive ventilation in the delivery room, implementing chin-straps for all infants on CPAP or NIPPV, aligning and engaging NICU staff, conducting monthly multidisciplinary respiratory care meetings, and sharing success stories.