EVERY KID, EVERY TIME

A Pediatric Patient Safety Initiative

GoalsImprove 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

0102030405060708090

100

Population* Bedspaces Nurses Physicians

Zone 1 Zone 3 Zone 5

%

*Source: 2005 Population Estimates for Public Health Assessment, Washington State Department of Health.

Pediatric Resources Mis-Match

A

0102030405060708090

100

Population* Bedspaces Nurses Physicians

Zone 1 Zone 3 Zone 5

%

*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 Care For Disaster Care

Measure Child and Assign Color Zone?? Child measures in Broselow “white”?? I need the “white”Ambu mask?? 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 TRIAGEPediatric 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 TRIAGEPediatric 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 transferTo inpatient from ED

Chart audit

IN THE FIELDPediatric patient

assessed in the fieldby Medic/banded with

appropriate colored band Band with appropriatecolored wrist band

Obtain weight when patient stable. Color assignmentis based on length for the

purpose of supplies

Quality data

collection

Generate Weight Specific

Medication sheet

“Prevalence-style” audits ofProcess compliance in ED

And on inpatient unit atPre-determined intervals

Pediatric Emergency Cartavail with full complement

of meds and suppliesin ED

Every Kid, Every Time

You can make a difference inthe care of kidsat 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