Becker's Clinical Quality & Infection Control

52 QUALITY IMPROVEMENT & MEASUREMENT How Cincinnati Children's cut hospitalization rates 20% among high-risk youth By Mackenzie Bean A population health initiative tar- geting Ohio children in high-risk neighborhoods could be used as a national model to help reduce pediatric hos- pitalizations, according to a study published in Health Affairs. For the study, researchers from Cincin- nati Children's Hospital Medical Center developed a population health improvement initiative for two high-morbidity, high-pov- erty neighborhoods in Cincinnati. e initiative included real-time analy- sis of EHR data to identify "hot spots" in neighborhoods where children needed additional support. Researchers also worked to improve chronic disease management, eliminate care gaps and mitigate social risks, such as housing instability or poor access to medications. e hospitalization rate for children in the two neighborhoods fell by 20 percent be- tween the study's baseline period (July 2012 to June 2015) and the improvement period (July 2015 to June 2018). e inpatient bed- day rate also dropped by 18 percent over the same time period. Demographically similar neighborhoods that were not involved with the population health initiative did not show similar decreases. "We have made early progress toward keeping children out of the hospital. We now seek to take what we have learned and push toward scale and spread," researchers concluded. n Viewpoint: How to improve screening for social determinants of health By Anne-Marie Kommers A s professional societies increasingly call for clinicians to screen patients for social determinants of health, it is important to re- view and evaluate the best practices for these screenings, wrote Karina W. Davidson, PhD, and Thomas McGinn, MD, in an opinion piece for JAMA. The authors outlined two primary concerns clinicians have about per- forming the screenings. First, they worry the screenings could decrease the time they have to spend on patients' medical care. Second, clini- cians lack confidence in their ability to address social determinants of health and say they lack time and resources for the screenings. To address these concerns, the authors summarized some of the best practices in social determinant screenings: 1. Create a referral list and identify social screening needs. A list of local community services, compiled with the help of public health departments and mental health organizations, can help clinicians refer patients to other services more quickly, the authors wrote. 2. Use integrated care models. A co-location treatment model integrates social service workers and resources with clinical practice while also destig- matizing patients' social service needs, according to the authors. 3. Use technology. Clinicians can use the CLEAR toolkit, which elec- tronically aggregates local resources and identifies which social deter- minant screenings are appropriate for specific populations, among oth- er innovations. It is possible that such interventions will save clinicians time they can spend with patients, but the authors suggest doing more research on the impact of these technologies in clinical practices. n The Joint Commission releases maternal care safety standards By Anne-Marie Kommers T he Joint Commission has released two new maternal care safety standards, which aim to reduce postpartum hem- orrhage and severe hypertension/pre-ec- lampsia in pregnant women and mothers, according to U.S. News & World Report. The new standards, released Aug. 29, come amid growing concerns over the quality of maternal care in U.S. hospitals. About 700 women die from pregnancy-related issues each year in the U.S., and the rate more than doubled between 1987 and 2015. The U.S. is the only developed country where mater- nal mortality rates are rising, according to a report from ProPublica and NPR. The two standards include 13 new hospital requirements, which will take effect in July 2020. The requirements for treating and detecting postpartum hemorrhage include supply kits for quick emergency treatment and annual practice drills for staff members. To address severe hypertension/pre-eclamp- sia, hospitals must devise procedures on measuring high blood pressure and transfer- ring women to other facilities. n

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