Transcript Document

Milestones from the Past /
A Spotlight on the Future
• Quality Improvement
• Operations Management
• Research
Randall Wetzel, MD, MBA
- Chief Executive Officer, VPS
- VPS Board Member
- Chairman, Department of Anesthesiology Critical
Care Medicine, Children’s Hospital Los Angeles
The MISSION of VPS
To improve critical care quality and
outcomes for all children and their
families through collaborative high
quality data management and
actionable comparative reports for
clinicians and other health care
leaders.
Participating Units In VPS: 124
140
January 2002 - March 2015
Cardiac ICU
120
Pediatric ICU
Number of ICUs Participating
100
80
60
40
20
0
2002 2002 2003 2003 2004 2004 2005 2005 2006 2006 2007 2007 2008 2008 2009 2009 2010 2010 2011 2011 2012 2012 2013 2013 2014 2014 2015
Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1
Year and Quarter
800,000
2002 Q1
2002 Q2
2002 Q3
2002 Q4
2003 Q1
2003 Q2
2003 Q3
2003 Q4
2004 Q1
2004 Q2
2004 Q3
2004 Q4
2005 Q1
2005 Q2
2005 Q3
2005 Q4
2006 Q1
2006 Q2
2006 Q3
2006 Q4
2007 Q1
2007 Q2
2007 Q3
2007 Q4
2008 Q1
2008 Q2
2008 Q3
2008 Q4
Final Desktop
Web 1 (Dec 2009)
Web 2 (July 2010)
Web 3 (Dec 2010)
Web 4 (Feb 2011)
Web 5 (May 2011)
Web 6 (Aug 2011)
Web 7 (Nov 2011)
Web 8 (Q1 2012)
Web 9 (Q2 2012)
Web 10 (Q3 2012)
Web 11 (Q4 2012)
Web 12 (Q1 2013)
Web 13 (Q2 2013)
Web 14 (Q3 2013)
Web 15 (Q4 2013)
Web 16 (Q1 2014)
Web 17 (Q2 2014)
Web 18 (Q3 2014)
Web 19 (Q4 2014)
Web 20 (Q1 2015)
The VPS Registry
900,000
VPS’s Total Current Count = 840,130 Cases
700,000
600,000
500,000
Case Count Desktop
Case Count Web
400,000
300,000
200,000
100,000
0
Quarter and Year
VPS Enhancements
900,000
800,000
700,000
600,000
500,000
VPS WEB
VPS BETA
Version
VPS Comparative
Database Started
Minimum dataset
plus
non-required
fields
400,000
VPS v3.5
VPS v4.1
VPS v5.0
Risk
Adjustment
PIM 2
(required)
PRISM 2
PRISM 3
Data
Collection
Profiles
(completed
PRISM 3
individual
scores
non-required
fields)
PCPC /
POPC Added
User
requested
PELOD
Cardiac Module
Quality Module
Diagnosis/Procedure Enhancements
Post-Index Scoring PIM/PRISM
Adjusted LOS Recalibrated
myReports
PICSIM
PIM 3
improvements
Site Profiles
Initiated
(comparison
group
developed)
300,000
200,000
100,000
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
FD
W1
W2
W3
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
0
2002
2003
2004
2005
2006
2007
2008
2011
2012
2013
2014
2015
VPS: The Initial Vision
• Back in 1997, Dr. Tom Rice and Dr. Randall Wetzel…..
VPS: Our Roots
• 1997: Collaboration between NACHRI PICU FOCUS group
and CHLA’s Virtual Pediatric Intensive Care Unit (VPICU)
– Goal: Create data solutions to support the improvement and
research interests of pediatric critical care clinicians and leaders
• Critical Care Clinicians, ICU Administrators, hospital
leaders, and others developed the first data collection
system
• The National Outcomes Center (CHHS, Milwaukee) joined
VPS to provide quality control, scientific and reporting
services
Completed VPS Reports: 1,630
VPS Annual, Quarterly and CCS Reports
31
568
Annual
Quarterly
1031
* since 2004
CCS
Use of VPS Data for Research
Sample of Recent Research Requests
•
PICU Volume and Outcomes
•
Validation of the PIM2 Risk of Mortality Tool in the United States
•
Predictive Models of Readmission to the PICU
•
Deaths in the PICU: Timing and Associations
•
Development of a risk-adjusted morbidity tool for the pediatric intensive care unit
•
Developing a methodology to benchmark PICU functional outcomes
•
Racial and Ethnic Health Care Disparities in the PICU: Acute Respiratory Failure
•
The use of Rotary Wing Interfacility Transport Decreases Mortality for Pediatric
Patients Admitted to PICUs
•
The Epidemiology of Catheter-Associated Bloodstream Infections in a Multi-Center
•
Ethnic differences in timing of stages of Single Ventricle Palliation and its impact on
Outcome
•
Respiratory Failure in Children with Acute Asthma
•
Ventilator Associated Pneumonia Registry
•
Early Enteral Nutrition in the PICU
94 Topics in the
VPS Research
Database
VPS Reporting Services
• myReports: On demand querying of data by users with requisite access
• Standardized Reports: Generate reports on demand by users
• Data Downloads: Users access data with ability to manipulate in
Excel or Access
• Annual and Quarterly Comparative Program
Performance Reports
– User defined comparison group
– Statistically analyzed and professionally presented
– One-on-one consultation with each unit to interpret results/generation of
recommendations for improvement
• Ad Hoc Data Requests
• Coming June 2015: VPS Analytics
VPS Cardiac
Cardiac Surgical Specific Risk Adjustment
Allows for Stronger Comparisons
Pediatric Index of Cardiac Surgical
Intensive Care Mortality (PICSIM score)
* Stay Tuned for the Dr. Howard Jeffries
Presentation, Thursday @ 10:50a
VPS Cardiac
• Supports both free standing CICUs and mixed PICUs to
strengthen the ability to compare outcomes and benchmark
best practices.
• Allows following patients across the continuum of care.
• Promotes guidance of future developments through
collaboration to improve the overall care of cardiac patients
• Facilitates current and future program advancements through
a dynamic alliance of cardiac advisory team physicians.
• Supports group research efforts to strengthen the knowledge
base and improve pediatric cardiac critical care.
The VPS Quality Module
• Developed to support the needs of our customers in
providing data for required and voluntary reporting
• Includes the three pediatric critical care core
measures endorsed by the National Quality Forum
– PRISM 3 standardized mortality ratio, PRISM 3 adjusted length of stay,
and unplanned readmission rate within 24 hours including case level
review of all unplanned readmissions
– Baseline and ongoing pain assessment/reassessment (previously
endorsed by NQF and required by The Joint Commission)
• For on demand production of automated reports to
support unannounced visits and urgent requests for
data
Questions?
We have
come a
long way
Together!