Post on 14-Dec-2015
Milestones from the Past / A Spotlight on the Future
• Quality Improvement• Operations Management• Research
Randall Wetzel, MD, MBA- Chief Executive Officer, VPS- VPS Board Member- Chairman, Department of Anesthesiology Critical Care Medicine, Children’s Hospital Los Angeles
The MISSION of VPS
To improve critical care quality and outcomes for all children and their families through collaborative high
quality data management and actionable comparative reports for
clinicians and other health care leaders.
Participating Units In VPS: 124VPS Participating Units From January 2002 through November 2014Current Participating Units = 127 Units
2002 Q1
2002 Q3
2003 Q1
2003 Q3
2004 Q1
2004 Q3
2005 Q1
2005 Q3
2006 Q1
2006 Q3
2007 Q1
2007 Q3
2008 Q1
2008 Q3
2009 Q1
2009 Q3
2010 Q1
2010 Q3
2011 Q1
2011 Q3
2012 Q1
2012 Q3
2013 Q1
2013 Q3
2014 Q1
2014 Q3
2015 Q1
0
20
40
60
80
100
120
140
January 2002 - March 2015
Cardiac ICU
Pediatric ICU
Year and Quarter
Num
ber o
f ICU
s Par
ticip
ating
2002
Q1
2002
Q2
2002
Q3
2002
Q4
2003
Q1
2003
Q2
2003
Q3
2003
Q4
2004
Q1
2004
Q2
2004
Q3
2004
Q4
2005
Q1
2005
Q2
2005
Q3
2005
Q4
2006
Q1
2006
Q2
2006
Q3
2006
Q4
2007
Q1
2007
Q2
2007
Q3
2007
Q4
2008
Q1
2008
Q2
2008
Q3
2008
Q4
Fina
l Des
ktop
Web
1 (D
ec 2
009)
Web
2 (J
uly
2010
)
Web
3 (D
ec 2
010)
Web
4 (F
eb 2
011)
Web
5 (M
ay 2
011)
Web
6 (A
ug 2
011)
Web
7 (N
ov 2
011)
Web
8 (Q
1 20
12)
Web
9 (Q
2 20
12)
Web
10
(Q3
2012
)
Web
11
(Q4
2012
)
Web
12
(Q1
2013
)
Web
13
(Q2
2013
)
Web
14
(Q3
2013
)
Web
15
(Q4
2013
)
Web
16
(Q1
2014
)
Web
17
(Q2
2014
)
Web
18
(Q3
2014
)
Web
19
(Q4
2014
)
Web
20
(Q1
2015
)
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000VPS’s Total Current Count = 840,130 Cases
Case Count Desktop Case Count Web
Quarter and Year
Coun
t of C
ases
The VPS RegistryVPS Participating Units From January 2002 through November 2014
Current Participating Units = 127 Units
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4 FD W1
W2
W3
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
2015
VPS Enhancements
VPS Comparative Database Started
Risk Adjustment
PIM 2 (required)PRISM 2PRISM 3
PCPC / POPC Added
Site Profiles Initiated
(comparison group
developed)
VPS BETA Version
VPS v3.5 VPS v4.1 VPS v5.0
Data Collection Profiles
(completed non-required
fields)
User requested
improvements
PRISM 3 individual
scores
PELOD
VPS WEBCardiac Module Quality ModuleDiagnosis/Procedure Enhancements Post-Index Scoring PIM/PRISM Adjusted LOS Recalibrated myReports PICSIM PIM 3
2002 2003 2004 2005 2006 2007 2008 2011 2012 2013
Minimum dataset plus
non-required fields
2014
VPS: The Initial Vision• Back in 1997, Dr. Tom Rice and Dr. Randall Wetzel…..
VPS: Our Roots• 1997: Collaboration between NACHRI PICU FOCUS group
and CHLA’s Virtual Pediatric Intensive Care Unit (VPICU)– Goal: Create data solutions to support the improvement and
research interests of pediatric critical care clinicians and leaders
• Critical Care Clinicians, ICU Administrators, hospital leaders, and others developed the first data collection system
• The National Outcomes Center (CHHS, Milwaukee) joined VPS to provide quality control, scientific and reporting services
* since 2004
568
1031
31
AnnualQuarterlyCCS
VPS Annual, Quarterly and CCS Reports
Completed VPS Reports: 1,630
Use of VPS Data for Research Sample of Recent Research Requests• PICU Volume and Outcomes• Validation of the PIM2 Risk of Mortality Tool in the United States • Predictive Models of Readmission to the PICU• Deaths in the PICU: Timing and Associations• Development of a risk-adjusted morbidity tool for the pediatric intensive care unit• Developing a methodology to benchmark PICU functional outcomes• Racial and Ethnic Health Care Disparities in the PICU: Acute Respiratory Failure• The use of Rotary Wing Interfacility Transport Decreases Mortality for Pediatric
Patients Admitted to PICUs• The Epidemiology of Catheter-Associated Bloodstream Infections in a Multi-Center • Ethnic differences in timing of stages of Single Ventricle Palliation and its impact on
Outcome• Respiratory Failure in Children with Acute Asthma• Ventilator Associated Pneumonia Registry• Early Enteral Nutrition in the PICU
94 Topics in the VPS Research
Database
VPS Reporting Services• myReports: On demand querying of data by users with requisite access
• Standardized Reports: Generate reports on demand by users
• Data Downloads: Users access data with ability to manipulate in Excel or Access
• Annual and Quarterly Comparative Program Performance Reports– User defined comparison group– Statistically analyzed and professionally presented– One-on-one consultation with each unit to interpret results/generation
of recommendations for improvement
• Ad Hoc Data Requests• Coming June 2015: VPS Analytics
VPS Cardiac
Cardiac Surgical Specific Risk Adjustment Allows for Stronger Comparisons
Pediatric Index of Cardiac Surgical Intensive Care Mortality (PICSIM score)
* Stay Tuned for the Dr. Howard Jeffries Presentation, Thursday @ 10:50a
VPS Cardiac• Supports both free standing CICUs and mixed PICUs to
strengthen the ability to compare outcomes and benchmark best practices.
• Allows following patients across the continuum of care.• Promotes guidance of future developments through
collaboration to improve the overall care of cardiac patients • Facilitates current and future program advancements through
a dynamic alliance of cardiac advisory team physicians.• Supports group research efforts to strengthen the knowledge
base and improve pediatric cardiac critical care.
The VPS Quality Module
• Developed to support the needs of our customers in providing data for required and voluntary reporting
• Includes the three pediatric critical care core measures endorsed by the National Quality Forum – PRISM 3 standardized mortality ratio, PRISM 3 adjusted length of stay, and
unplanned readmission rate within 24 hours including case level review of all unplanned readmissions
– Baseline and ongoing pain assessment/reassessment (previously endorsed by NQF and required by The Joint Commission)
• For on demand production of automated reports to support unannounced visits and urgent requests for data
Questions?
We have come a long wayTogether!