Impact of a Standardized Treatment Guideline for Pediatric Iatrogenic Opioid Dependence: A Quality Improvement Initiative.

Objectives: To determine whether utilization of a hospital-based clinical practice guideline for the care of pediatric iatrogenic opioid dependence (IOD) would promote a decrease in opioid exposure and improve management of opioid abstinence syndrome (AS).

Methods: This study is a retrospective chart review of critically ill patients from a tertiary care children's hospital. Inclusion criteria included mechanically ventilated patients up to 18 years of age who received continuous opioid infusions for at least 7 days and any length of methadone administration.

Quality improvement processes in growing a service line. The myriad of opportunities.

The authors describe the evolution of a pediatric quality management program in a large community hospital that has rapidly grown in size and complexity to be a tertiary care center. Positive changes in senior leadership expectations, physician involvement, and training in performance improvement methodologies contributed to the development of a more comprehensive program. The authors from several specialty areas of the pediatric service illustrate three quality and performance improvement projects that they used in coping with the challenges of fast growth and higher acuity.