What is Quality?

We know that when your child is receiving medical care you want the peace of mind of knowing your child’s care is exceptional, reliable and provided by expert clinicians. That’s why CHOC Children’s has worked hard to build a culture of safety, quality and collaboration. We’re proud to have cultivated an environment that not only prioritizes safety, but also emphasizes sharing and openness so that we can all learn from best practices.  All our quality efforts influence one or more of the six “Domains of Quality” as defined by the Institute of Medicine:

  • Safe: Avoiding harm to patients from the care that is intended to help them
  • Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively)
  • Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical decisions
  • Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care
  • Efficient: Avoiding waste, including waste of equipment, supplies, ideas and energy
  • Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status

Our Results

Patient Safety

CHOC’s efforts to keep your children safe include preventing any harmful events that could occur when during a hospitalization, surgery or invasive procedure. These include:

  • adverse drug events,
  • catheter related urinary tract infections,
  • catheter-related bloodstream infections,
  • serious falls,
  • serious pressure injuries,
  • surgical site infections, and
  • unplanned extubations (if your child has a tube and mechanical device to help them breathe).

CHOC actively tracks and strives to decrease these events.

Hospital-Acquired Conditions at CHOC Children’s
This graph shows a favorable trend in reducing the number of Hospital-Acquired Conditions at CHOC Children’s in the last 4 years. The apparent increase in Fiscal Year 18 is due to a measurement change that allowed a larger number of these events to be included in the definition.

Asthma care management

At CHOC, we specialize in diagnosing and treating kids with asthma. We use nationally endorsed clinical guidelines for treating acute episodes and helping you and your child prevent symptoms from worsening. If your child is hospitalized for asthma, these are some ways we measure how well we treat children with asthma.

The number of days a child with asthma stays in the hospital at CHOC.
The number of days a child with asthma stays in the hospital at CHOC is consistently less than the national average for other children’s hospitals.
Asthma readmission rates for CHOC Children's
We know we’re successful in treating asthma and educating about care when patients don’t need to come back to the hospital. CHOC’s performance in this area has consistently improved, and 2018 rates for readmissions within seven days were less than the national average.
Asthma Action Plan (AAP) Implemented
We set the bar high when it comes to communicating about your child’s treatment. The care team reviews your Asthma Action Plan (AAP) before you leave the hospital.

Keeping Your Child Well

The American Academy of Pediatrics recommends that all children, between 3 and 6 years of age, receive an annual check-up with their pediatrician. These visits are designed to assess growth and development, screen for early signs of disease, and provide education regarding safety and prevention. Additionally, these visits provide an opportunity for children to receive recommended childhood immunizations, designed to prevent disease. By following this recommended schedule, you can take an active role in assuring your child remains happy and healthy in ensuring children 3 to 6 years old receive annual well child visits.

Well-child visits in 3rd-6th years of life
For the last 4 years, more than 79% of CHOC 3 to 6 year-old children receive their Well Child Visits, which is much higher than the national average of approximately 72%.

There are many important reasons to assure children entering adolescence are receiving timely medical care. Adolescence is a time of tremendous growth and numerous developmental changes related to ongoing maturity. Annual visits with your pediatrician are a wonderful way to assure your developing young adult is following the expected growth and developmental milestones for her/his age. These annual visits are also important because adolescence is a time where young people take risks and have a much higher incidence of accidents and injuries. Part of the annual adolescent well care visit deals with education around accident and injury prevention as well as counseling on safe practices as the child develops. In addition, there are a number of very important immunizations adolescents require that boost immunity from childhood vaccines and help protect against certain forms of cancer. Please remember to have your maturing adolescent ages 12 and older evaluated on an annual basis to ensure the best possible outcomes for their future. The relatively low numbers across the country show how difficult it can be to deliver necessary care to adolescent children.

Adolescent Well Care Visits
More than 59% of CHOC Children’s adolescent patients make their Well Care Visits, which is much higher than the national average of 50%.

Patient Experience

Our team is dedicated to providing world-class care, and the best CHOC experience for our patients and their families. As partners in care, we regularly reach out to our families after a visit or hospitalization and ask them to respond to a survey that uses a nationally recognized vendor, NRC Health. The patient experience scores, ratings and feedback help us improve patient experience, as well as celebrate our successes and recognize staff.

Our goal is to provide you or prospective patients and families with more objective and meaningful information into the patient and family experience. The data in this graph displays the overall rating of a visit or hospitalization, sometimes referred to as “top box scores.” Responses for this question are measured on a scale of zero to 10, with 9 and 10 being the “top box”, or best hospital stay or visit possible.

NRC Health provides us with national pediatric comparative benchmarks.

Patient Experience - CCO Inpatient
CHOC Children’s Inpatient results show improvement over 5 years with Fiscal Years 2018 and 2019 performing better than the Children’s Hospitals Benchmark.
Patient Experience - CCO Primary Care Clinics
CHOC Children’s Primary Care Clinics results show improvement over 5 years with Fiscal Year 2019 performing better than the Children’s Hospitals Benchmark.
Patient Experience - CCO Specialty Care Clinics
CHOC Children’s Specialty Clinics results show improvement over 5 years with Fiscal Years 2017, 2018 and 2019 performing better than the Children’s Hospitals Benchmark.

Serious Safety Events

Reducing medical error and the possible harm that it can cause is one of the most important things that hospitals, clinics and offices can do. This can be very challenging given how complex medical care can be. Nonetheless, our highest goal is to eliminate patient harm.

Enterprise-wide (CCO+CCMH) Serious Safety Event
At CHOC Children’s, we measure serious harm events that we feel were preventable. This graph shows that due to our efforts to improve quality, patient safety and healthcare design, while also improving the engagement of patients and families, these events have decreased over 95% in the last 10 years (FY = Fiscal Year).

We need your help to ensure that every patient in our care is kept safe.

Mom looking down at infant she is holding.

CHOC actively advocates that parents be part of the safety team for their child, wherever they interact in our network of pediatric providers or hospitals. You can help participate by:

  • Being an advocate for your child.
  • Sharing unique things about your child with caregivers.
  • Washing your hands and ensure they wash, too. Don’t be afraid to remind doctors and nurses about washing their hands before working with you.
  • Staying clean and dry. If your child has an intravenous catheter or wound, keep the skin around the dressing clean and dry and let your caregiver knows if it gets wet or loose.
  • Watching for red or irritated skin and notify your child’s caregivers if you notice anything new.
  • Knowing the medications your child is receiving.
  • Being prepared when going home or after your office visit. Make sure you know what medications and or treatments your child needs.
  • Asking what you should watch for that will require a call back to your child’s doctor’s office to ask questions.