title: A new framework for quality partnerships in Children's Hospitals.
abstract: Children's hospitals and their affiliated departments of pediatrics often pursue separate programs in quality and safety; by integrating these programs, they can accelerate progress. Hospital executives and pediatric department chairs from 14 children's hospitals have been exploring practical approaches for integrating quality programs. Three components provide focus: (1) alignment of quality priorities and resources across the organizations; (2) education and training for physicians in the science of improvement; and (3) professional development and career progression for physicians in recognition of quality-improvement activities. Process and resource requirements are identified for each component, and specific, actionable steps are identified. The action steps are arrayed on a continuum from basic to advanced integration. The resulting matrix serves as an "integration framework," useful to a hospital and its pediatric academic department at any stage of integration for assessing its current state, plotting a path toward further integration, tracking its progress, and identifying potential collaborators and models of advanced integration. The framework contributes to health care's quality-improvement movement in multiple ways: it addresses a basic impediment to quality and safety improvement; it is an implementable model for integrating quality programs; it offers career-advancement potential for physicians interested in quality; it helps optimize investments in quality and safety; and it can be applied both within a single children's hospital and across multiple children's hospitals. Widespread adoption of the integration framework could have a transformative effect on the children's hospital sector, not the least of which is improved quality and safety on a large scale.
authors.affiliation: Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, Ohio State University, College of Medicine, Columbus, Ohio, USA. flevy@nshs.edu
authors.forename: Fiona Howard
authors.initials: FH
authors.lastname: Levy
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Brilli
authors.forename: Lewis R
authors.initials: LR
authors.lastname: First
authors.forename: Daniel
authors.initials: D
authors.lastname: Hyman
authors.forename: Alan E
authors.initials: AE
authors.lastname: Kohrt
authors.forename: Stephen
authors.initials: S
authors.lastname: Ludwig
authors.forename: Paul V
authors.initials: PV
authors.lastname: Miles
authors.forename: Marian
authors.initials: M
authors.lastname: Saffer
mesh_terms: D002648:Child; D002662:Child Health Services / Q000592:standards*; D006748:Hospital Departments / Q000592:standards; D006776:Hospitals, Pediatric / Q000592:standards*; D006801:Humans; D011785:Quality Assurance, Health Care / Q000379:methods*; D014481:United States