Recommendations for Enhancing Pediatric Data on the FloridaCompareCare Website

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Recommendations for Enhancing Pediatric Data on
the FloridaCompareCare Website

• October 2006

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Composition of Workgroup

• All Children's Hospital
• Arnold Palmer Hospital for Children
• Chris Evert Women and Children's Center (North
  Broward Hospital District)
• Jackson Memorial Children's Hospital
• Joe DiMaggio Children's Hospital (Memorial Health
  System, Hollywood)
• Miami Children's Hospital
• Shands Children's Hospital at the Univ. of FL
• St. Joseph's Children's Hospital
• Wolfson Children's Hospital

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Recommendations

• Pediatric information should be clearly
  delineated from information on adults
• Definition of normal newborn should be revised
• Risk adjustment for pediatric conditions should
  be based only on the pediatric population and be
  specific to that indicator
• Exclude charge and day outliers from the data
• Use selected AHRQ Pediatric Quality Indicators
  (PDI) for outcomes reporting

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Recommendations

• Provide information on ambulatory surgery
• conditions for children
• Adopt the 3M methodology for readmission rate
  reporting with special considerations for
  pediatric conditions
• Conduct focus groups to evaluate needs of parents
  for pediatric data

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Recommendations on the Preventable Readmission
Methodology

• Readmissions should be based on those occurring
  within 15 days of the initial admission
• Readmission rates should be segregated for
  infants (up to one year of age) and non-infants
  (1 through 17 years)
• Readmission rates should be limited to
  readmissions for the same condition and only for
  those conditions in which a readmission is not
  expected

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AHRQ PDI Measures Which Could Be Used

• Foreign body left in after procedure
• Pediatric heart surgery volume
• Postoperative wound dehiscence
• Transfusion reaction
• Iatrogenic pneumothorax in neonates at risk
• Iatrogenic pneumothorax in non-neonates

Use only if exclude cardiothoracic procedures as
recommended by the AHRQ Techical workgoup
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AHRQ PDIs Which Should Be Delayed Until POA Coding

• Decubitus ulcer
• Postoperative sepsis
• Selected infections due to medical care

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PDIs Not Recommended for Public Reporting

• Accidental puncture and laceration
• Pediatric heart surgery mortality
• Postoperative hemorrhage and hematoma
• Postoperative respiratory failure

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Pediatric Ambulatory Surgery Conditions for
FloridaCompareCare

• Tonsil and adenoid removal
• Ear tubes placement
• Diagnostic upper GI endoscopy
• Circumcision
• Hernia and/or hydrocele repair
• Cleft palate repair
• Arthroscopy
• Strabismus
• Treatment of fractures
• Lower gastrointestinal endoscopy
• Diagnostic cardiac catheterization
• Bronchoscopy

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Questions?