1. Track IC: Pediatric Quality and Safety Human Factors in Surgical Care: Ethnographic and Empirical Evidence Fundamental Issues in Rewarding Performance in Pediatric Healthcare Enhancing the Medical Home for Children with Special Needs: A Quantitative Approach The Role of Barcodes in Reducing Pediatric Drug Adverse Events

2. The Quality Colloquium Boston, MA August 20, 2008 Paul V. Miles MD Senior Vice President Quality and Maintenance of Certification American Board of Pediatrics If The Horse Dies, Get Off: A New Revolution in Healthcare No conflicts of interest to report

3. Three New Activities in Physician Quality and Safety You May Not Be Aware Of Competency in quality improvement is now required for all physicians to maintain board certification Knowledge about patient safety is now required for all physicians to maintain board certification: ABMS Patient Safety Improvement Program www.ABMS.orgwww.ABMS.org National collaborative to reduce pediatric catheter associated blood stream infections in PICUs

4. Physician Quality From “trust me, I am a physician” to “show me the data” Physicians have a professional obligation to measure and continually improve the quality of the care they and their care team deliver And, they have a professional obligation to assess and continually improve their professional development

5. What do we mean by : “Best Quality?” Quality = Best science + Context Context: (what the patient wants and needs), (provider variables), (micro system), (macro system) IOM six dimensions of quality: safe, timely, effective, efficient, equitable, patient centered

6. Maintenance of Certification Six Core Physician Competencies Patient care Medical knowledge Interpersonal and communication skills Professionalism Assess and improve quality of care Systems-based practice (Adopted by the ACGME and all twenty four ABMS specialty boards)

7. Acute Lymphoid Leukemia Simone J., Lyons, J: J Clin Oncology 1998 Sep;16(9):2904-5 5 year survival rate Bill Nugent

8. NACHRI Eliminating Bloodstream Infections In the first 6 months, 29 children’s hospitals reduced infection rates in the PICU by nearly 70 percent by adhering to a rigid set of evidence- based practices shown to prevent infections in children. 70% improvement: 15 lives saved, 80 infections prevented, $6.4 million not spent in the first 6 months

9. Cystic Fibrosis Care Median FEV1 CF Patients 6-12 yrs CFF National Patient Registry, 2004 *Wang & Hankinson equations

10. “Perfect Care”: composite measure of severity classified, identified management plan, and controller medications for patients with persistent asthma Copyright © 2005 Cincinnati Children’s Hospital Medical Center; all rights reserved Cumulative % of Asthma Population with "Perfect Care": Network and Select Practices