Todd Carpenter, MD, and his team care for some of the sickest kids who visit Children’s Hospital Colorado. Yet the outcomes they experience are better than most: patients in their pediatric intensive care unit survive at better than expected rates, and they leave the PICU sooner than similar patients at similar hospitals.
As the unit’s medical director, these results are a source of pride for Dr. Carpenter. But this doesn’t mean he is content.
“There are still a lot of kids experiencing outcomes that are less than what we want for our children,” he said. “We intend to change this.”
As a basic scientist, Dr. Carpenter spent most of his career developing new knowledge with the aim of advancing pediatric critical care. When he accepted the role of clinical medical director of the PICU two years ago, Dr. Carpenter brought with him a keen eye for data—something Kurt Stenmark, MD, director of the division of pediatric critical care medicine, believes has benefited patients and caregivers alike.
“Todd has earned the respect of everyone in our section by staying focused on the data. And he’s given everyone in the department a say in how they approach quality and safety. If you show him the data—what you have and what you plan to collect—he’ll support your project. It’s something we all appreciate,” said Dr. Stenmark.
Before Dr. Carpenter took over the role of medical director, the department had a number of quality and safety initiatives in place. Yet overall the projects lacked cohesiveness and buy in, so he formed a multidisciplinary Quality Improvement and Practice Safety Council.
The council meets monthly and everyone in the department is invited. Together they review quality metrics, receive updates on ongoing projects, and review project proposals.
“When we first started down this road, one of my comments was that we were really good starters but not very good finishers. Compared to a few years ago, we’re starting fewer projects. But those we are working on have been sustainable across the long-term.”
The impact of this shift from disparate projects to unit-based approaches has also brought the team closer.
“In the past, there was a perception that new guidelines appeared from nowhere,” he said. “Keeping our projects out in the open, and having those involved who want to be involved, has helped people get on board with the changes that need to be implemented.”
Transparency of data and effort has also increased participation.
“Currently about 25 people attend the monthly meeting. It may not sound like much, but considering the prior meetings only had four or five people attend, it’s a big difference,” he said.
According to Dan Hyman, MD, chief quality and safety officer of Children’s Colorado, Dr. Carpenter has done an outstanding job leading the efforts of the pediatric intensive care unit. “He is a tremendous leader who combines the unusual skill of savvy and sophisticated use of data and analytics with exceptional team leadership skills.”
Both Dr. Hyman and Dr. Carpenter are pleased with the unit’s outcomes, especially considering the unit’s growth.
“Over the last decade, our patient volumes have been increasing by about 10 percent each year, and our faculty members have increased by almost one-third. We’re keeping a careful eye on these trends as we move forward, knowing that this can pose a risk to efficiencies,” Dr. Carpenter said.
Although data gathering is central to the department’s quality and safety efforts, Dr. Carpenter believes they are elevating the care they provide by involving patients and families in conversations about quality.
“We invite our families to join rounds every day, hoping they will find it helpful to see the level of attention that goes into their child’s care. During our weekly quality rounds, we touch base with our doctors, nurses and staff, but also the family. I think it’s led to us becoming aware of a lot of issues, which provides us with a great opportunity to tweak our practices.”
As the unit continues to expand its quality and safety efforts, Dr. Carpenter has not lost sight of the need for advancements in science.
“We need to work every day to not just improve quality and efficiency of existing practices, but also to develop new technologies and treatments,” he said. “Hopefully I can make that happen in some way. If not personally, then I hope to set up systems that let other people push the frontier.”
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