EVERY KID, EVERY TIME A Pediatric Patient Safety Initiative

Goals  Improve pediatric patient safety across the continuum of care  Decrease clinician anxiety related to care of the pediatric patient  Enhance ED staff preparedness for potential mass casualty event

Why Every Kid, Every Time?  Pediatric resuscitations cause significant cognitive stress for care providers leading to a high potential for error  A standardized process such as “color coding” reduces cognitive stress, allowing clinicians to focus on assessment, prioritization, and interventions in a more effective fashion  “Color Coding” has been shown to decrease errors in care

King County Regional Emergency Coordination Zones

Pediatric Hospital Beds A

Pediatric Resources by Emergency Response Zone *Source: 2005 Population Estimates for Public Health Assessment, Washington State Department of Health.

Pediatric Resources Mis-Match A *Source: 2005 Population Estimates for Public Health Assessment, Washington State Department of Health Pediatric Hospital Beds In King County Our problem: The majority of kids live in East and South King Co. Valley Medical Center is in Zone 3, and the Eastside is Zone 1. The majority of pediatric resources are in Zone 5 (Seattle) Population and Resources by Zone

What this means?  Majority of pediatric beds, staff, and resources are in the greater Seattle area  Majority of pediatric patients reside in East and South King County  Valley Medical Center needs to be prepared to care for a potentially large number of pediatric patients who may not be able to get to care in Seattle in the event of a serious disaster  King Co. Health Dept Goal for 2011 states “80% of hospitals using “Color Coded Kids” approach to pediatric care by January

Why Every Kid, Every Time?  Makes size-related decision automatic based on the color assigned  Reduced cognitive stress leads to reduced errors  One pediatric casualty challenging enough…  Multiple patients to care for during a disaster  Math-free algorithms enhance “critical thinking” and save time For Routine ED CareFor Disaster Care

nMeasure Child and Assign Color Zone n?? Child measures in Broselow “white” n?? I need the “white” nAmbu mask n?? Give him a “white”dose of Epinephrine Resuscitation Scenario Should Go Like This…………….

Every Kid, Every Time Color Zone Resource Sheet

Patient Specific Medication sheet and Length Based Color Zone Sheet remains with patient ED TRIAGE Pediatric patient admitted via Triage area stable. Weigh and determine length with the Broselow Tape/initiate a Patient Weight Specific Medication Sheet and the Length Based Color Zone Sheet ED TRIAGE Pediatric patient admitted via Triage area unstable. Initiate Length Based Color Zone Sheet and Pediatric Emergency Cart and/or Color- specific Resp. Supply Bag at bedside On discharge or transfer To inpatient from ED Chart audit IN THE FIELD Pediatric patient assessed in the field by Medic/banded with appropriate colored band Band with appropriate colored wrist band Obtain weight when patient stable. Color assignment is based on length for the purpose of supplies Quality data collection Generate Weight Specific Medication sheet “Prevalence-style” audits of Process compliance in ED And on inpatient unit at Pre-determined intervals Pediatric Emergency Cart avail with full complement of meds and supplies in ED

Every Kid, Every Time  You can make a difference in the care of kids at Valley Medical Center

What Comes Next at VMC?  Education and competence validation of the healthcare teams in Emergency Department and Pediatrics Mother Baby Unit  Development of patient specific mediation sheet program by Pharmacy staff Fall 2010  “Go Live” for “Every Kid, Every Time Pediatric Patient Safety Initiative for the Emergency Department and Pediatrics Mother Baby Unit January 7, 2011