Children's Hospitals Today - Winter 2018 - 18

FEATURE / INNOVATION

OUTCOMES AND COST SAVINGS

TAKE FEWER CHEST X-RAYS

Steal
these ideas
Looking for inspiration in the
New Year? Take a closer look at
these eight easy-to-implement
ideas from your peers that
your hospital can use to drive
results into the future.
By Megan McDonnell Busenbark
Illustrations by Joe Moccia

18

CHILDREN'S HOSPITAL S TODAY Winter 2018

CHILDREN'S NATIONAL
HEALTH SYSTEM in
Washington, D.C., is
reducing unnecessary
chest X-rays in its NICU,
and improving outcomes
while driving down costs.
With guidance from the
American Academy of
Pediatrics, Children's
National decreased the
frequency of chest X-rays
used to verify positioning
of a child's ventilator tube
from daily to just twice a
week. Fewer X-rays means
a lower likelihood of an
accidental extubation-an
event that can cause
serious harm and, on
average, nearly doubles the
length of stay compared
to that of a newborn
whose breathing tube
remains in its proper
place. Fewer X-rays also
means less exposure to
radiation. To ensure the
team caused no harm,
the rate of unintended
extubations and concerns
from the clinical team were

monitored. For Michelande
Ridoré, M.S., the program
lead in Children's National's
Division of Neonatology,
the benefit is clear. "This
strategy is life-saving,"
Ridoré says. "We're reducing
a burden on a child and a
potentially worse outcome
if the tube had been
dislodged." Children's
hospitals can replicate
this strategy simply by
cutting back on the number
of these chest X-rays in
accordance with Children's
National's protocol.
Learn more: childrensnational
.org/nicu_quality_improvement

Getting results
After implementing
the program:

 Accidental
extubations
dropped from 1.18
events per 100
ventilator days to
0.41 events per 100
ventilator days-a
65 percent decrease
within five months
 The NICU's monthly
X-ray expenditure
decreased to
$159,424-nearly
$1.6 million in
annual savings


http://childrensnational.org/nicu_quality_improvement http://childrensnational.org/nicu_quality_improvement

Table of Contents for the Digital Edition of Children's Hospitals Today - Winter 2018

Contents
Children's Hospitals Today - Winter 2018 - Intro
Children's Hospitals Today - Winter 2018 - Cover1
Children's Hospitals Today - Winter 2018 - Cover2
Children's Hospitals Today - Winter 2018 - Contents
Children's Hospitals Today - Winter 2018 - 2
Children's Hospitals Today - Winter 2018 - 3
Children's Hospitals Today - Winter 2018 - 4
Children's Hospitals Today - Winter 2018 - 5
Children's Hospitals Today - Winter 2018 - 6
Children's Hospitals Today - Winter 2018 - 7
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