Choosing Wisely Campaign: Report Card and Achievable Benchmarks of Care for Children’s Hospitals

Abstract

A novel report card was developed on the basis of the SHM-CWC pediatric recommendations, including ABCs. We found variance in practices among institutions and gaps between hospital performances and ABCs. These findings represent a roadmap for improvement.

Impact of the Choosing Wisely® Campaign Recommendations for Hospitalized Children on Clinical Practice: Trends from 2008 to 2017

“…5 We initially developed a report card with five metrics derived from the CWC-SHM pediatric recommendations to help individual institutions and group practices to measure their performance and benchmark their results with peers. 6 The report card is available for hospital members of the Children's Hospital Association (CHA). 7 The current study analyzes the frequency of utilization and trends of five metrics included in the CHA/Pediatric Health Information System ® (PHIS) CWC report card in tertiary children's hospitals in the United States.…”

Getting an “A”: Report Cards for Reducing Health Care Waste

“…With this charge, the Society of Hospital Medicine (SHM) Pediatric Committee published 5 pediatric recommendations of unnecessary treatments, tests, or monitoring to be reduced: bronchodilator use for children with bronchiolitis, systemic steroids for children ,2 years of age with lower respiratory tract infection, anti-reflux medications for gastroesophageal reflux in infants, chest radiography for children with uncomplicated asthma or bronchiolitis, and continuous pulse oximetry in children with acute respiratory illness (unless on supplemental oxygen). 5 In this issue of Hospital Pediatrics, Reyes et al 6 describe the development of a novel "Report Card," which was developed by using the 5 pediatric recommendations from the SHM-CWC. The report card displays the hospital and similarly-matched peer performance, as well as the benchmark, for each of the 5 included metrics.…”

“…This ABC methodology has been previously used to establish realistic goals of care across different hospitals in different settings. [7][8][9] Reyes et al 6 used recommendations endorsed by the SHM-CWC group, and established an achievable goal for each metric across 32 hospitals participating in the Pediatric Health Information System (PHIS), which represents free-standing children' s hospitals across the country. This report card may be available for all PHIS participating members so institutions can use these data to focus their quality improvement efforts where there are significant outliers.…”

“…The majority of measures in every VIP project are overuse measures, which the network terms "value metrics," and this group has been successful in reducing unnecessary diagnostic tests and treatments for common inpatient conditions like bronchiolitis and pneumonia. 14,15 In this edition of Hospital Pediatrics, Reyes et al 6 have operationalized a novel report card for recommendations endorsed by the CWC. Reducing waste in our current health care system is a complicated process, and the national quality agenda to improve our health care system is moving too slowly.…”

“…We need both federal and local efforts to advocate for quality measurement based on evidence and science to see real progress. We applaud Reyes et al 6 for introducing a novel report card to help initiate local change to improve care for children by decreasing low-value care.…”