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Methods of Increasing Comprehensive and Efficient Patient Care: The Enhancement of a Pediatric Pulmonary Hypertension Program

Michelle Cash

Jean Giver

Russel Hirsch


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Conference: 2009 PH Resource Network Symposium

Release Date: 09.24.2009

Presentation Type: Abstracts

Michelle Bagby, RN, MSN, CNP; Jean Giver, RN, BSN; Russel Hirsch, MD
Cincinnati Children's Hospital Medical Center, Cincinnati, OH

BACKGROUNDPatient care today often involves coordination of a complex network of information databases and multidisciplinary teams. Lack of standardization and poor communication can lead to disjointed medical care, delayed decision-making duplication of work, and eventually results in suboptimal patient care and outcomes. Given the close monitoring pulmonary hypertension patients require, it is critical for information to be available to caregivers in an accurate, timely and reliable fashion. After a critical review of our own practices as well as a literature search, we have implemented a comprehensive pediatric health care delivery system in our Pulmonary Hypertension Service to efficiently coordinate care and streamline the monitoring process, with a goal to both increase the quality of patient care and the provider's work while reducing medical errors.

METHODSOur program provides comprehensive, high quality patient care utilizing a multidisciplinary team model, including the incorporation of a Nurse Practitioner (NP), use of information technology and professional networking. Cooperation amongst clinicians is a priority, and functions to close the knowledge gap of patient care issues and promotes consistency in care and case management. The NPs on the team function as both liaisons and independent providers, decreasing physician work burden. Daily rounds involve the exchange of ideas, review of patient progress and care plan, and focus on family/patient involvement and education. Consistency in patient care is also optimized via serial examination, and test review and is facilitated by the use of electronic databases.

RESULTSWhile our model of care has resulted in standardization that eliminates medical errors and miscommunication, it also allows for care to be individualized to each patient and family. Continued re-evaluation and evolution of our model has also allowed for anticipatory, rather than purely reactionary, decision making. Quality, patient-centered care, improved medical outcomes and patient/family satisfaction are results of the implementation of this program. Proper utilization of an NP increases family access to caregivers and reduces wait time. Information technology, including electronic prescribing and laboratory monitoring, allows for mainstreaming of medical information, increased efficiency and reduction of cost and errors while promoting standardization of care. Professional networking has expanded our patient care treatment options, allowing our patients to benefit from cutting edge research and new treatment recommendations. This more efficient approach has mainstreamed treatment and increased family access and quality of care.

CONCLUSIONSOur model of comprehensive and collaborative pediatric medical care in a Pediatric Pulmonary Hypertension Service results in improved family interaction and patient outcomes via timely treatment, informed decision making, efficient resource utilization, reduction of medical errors and increased staff satisfaction.