Case Management

Clinical protocols improve throughput at children's hospital

Case Management Monthly, January 1, 2011

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In an effort to enhance outcomes and standardize practice in pediatric patients, Children’s Hospital and Medical Center (CHMC) in Omaha, NE, created three sets of clinical protocols for three of the hospital’s high-volume DRGs. It worked. 

Since creating the evidence-based clinical protocols, CHMC has lowered its average LOS, decreased the usage of chest x-rays, established more appropriate use of antibiotics for bronchiolitis and community-acquired pneumonia, and reduced the readmission rate for asthma. 

Although the effort was successful, it wasn’t always easy, says Candi Pospisal, MS, BSN, RN, CMAC, manager of nursing case management at CHMC. The project involved many members of the patient care team, including physicians, case managers, nurses, IT, epidemiology, respiratory specialists, ED staff, and other disciplines involved in patient care and patient education. Bringing all these different roles to the table, searching the literature on best practices, creating computerized physician order entry (CPOE) order sets, and disseminating new information to staff and patient families was a yearlong process.

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