QI Collaboratives: Empowering practical solutions

How does one advocate for a formalized PECC role within his or her organization? How can system-level changes help ensure that the right pediatric equipment, supplies, and medications are available when needed? 

These are some of the questions participants aim to answer through the Pediatric Emergency Care Coordinator (PECC) Workforce Development Collaborative, which began in September and is currently transitioning from the learning phase to the implementation  phase. A total of 192 participants plan to design and implement quality improvement (QI) projects in this next phase, which is optional. (Learning session recordings and slides are available here.)

To date, the EMSC Innovation and Improvement Center (EIIC) has held six QI collaboratives on topics ranging from disaster preparedness to telehealth (EMSC’s first collaborative–the Facility Recognition Collaborative–was hosted by the National Resource Center and transitioned to EIIC in 2016.) Two new collaboratives are on the horizon for later this year: a mental health-focused collaborative, open to teams of practitioners who are interested in optimizing the clinical care processes for children presenting to their emergency department with acute suicidality and a disaster networking collaborative, which is intended to help the Pediatric Pandemic Network hub hospitals grow the pediatric voice within regional disaster planning efforts. Both collaboratives are anticipated to launch in late summer or early fall.

But what is a QI collaborative, and how do they work?

A framework for improvement

EIIC's QI collaboratives are based on the Institute for Healthcare Improvement’s (IHI) Breakthrough Series Model which was first outlined in 2003. Collaboratives are defined by the IHI as short-term (6- to 15-month) learning systems that bring together a large number of teams from various settings to seek improvement in a focused topic area (in EMSC’s case, pediatric emergency care). Collaboratives differ from most education programs in that they emphasize empowerment and engagement as opposed to passive learning. 

“Most often our QI collaboratives are thought of as training programs, where participants will receive simple, standard solutions to improve their pediatric readiness,” says Meredith Rodriguez, PhD, senior project manager for EIIC’s Collaboratives Domain, which coordinates all collaboratives. “In reality, a QI-based approach is not an easy one-size-fits-all solution and requires a fair amount of work and commitment from the participants. We provide a framework, but it is left to the participants to use this framework – with support from our subject matter experts – to develop a solution for their organization.”

Collaboratives typically follow a cyclical series of learning sessions, action periods, measurement and evaluation, and finally, summative publications or white papers. For example, the current PECC Workforce Development Collaborative has two phases. In the learning phase, there were seven monthly learning sessions, which focused on one area of pediatric readiness and how one might use the principles of quality improvement to drive improvement in that area. The current phase engages participants to use what they’ve learned to develop and implement a QI project to improve pediatric readiness in real-time and in their setting.

“By far, the most rewarding part of the collaboratives is hearing from our participants on how the work they’ve done in the collaborative has impacted the care of children,” says Rodriguez.

Ultimately, participation in a collaborative is about improving outcomes – quickly. According to Rodriguez, QI science can reduce the uptake time of evidence-based best practices into clinical practice down to 3-5 years instead of 10-20 years.To learn more about quality improvement in the EMSC program, see the 2019 white paper. 

Sustaining and building on lessons learned

EIIC's QI collaboratives, once completed, typically transition into communities of practice, which meet quarterly and aim to sustain and build on the resources and best practices identified during the collaborative. In addition, collaboratives often result in the development of toolkits of resources, which are available to all.

EIIC currently has four open communities of practice:

• Telehealth
• Pediatric Emergency Care Coordinator (prehospital-focused; currently on hold while the PECC Workforce Development Collaborative convenes)
• Pediatric Readiness (in collaboration with the American Academy of Pediatrics’ Section on Emergency Medicine’s Pediatric Readiness Project Subcommittee)
• Pediatric Readiness Recognition Programs

The Telehealth and Pediatric Readiness Recognition communities of practice both have meetings next month on April 26 and 27, respectively.

To learn more or get involved with a collaborative or community of practice, visit EIIC’s webpage. To stay up-to-date about upcoming collaboratives, join our mailing list.