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AAP Conference Preview: Get hands-on experience in improving quality of care :

October 7, 2016

Editor’s note: For more on educational sessions and events at the 2016 AAP National Conference & Exhibition in San Francisco, read the preview issue of AAP News Today. To register for the conference, visit

Take a common clinical scenario where care tends to vary across different settings. Then bring together those who provide that care, including primary care doctors, emergency department (ED) physicians, hospitalists and subspecialists.

That’s the idea behind an Interactive Group Forum titled “Building Quality Collaborations: the Primary Care, Emergency Department, Hospital Continuum (I1046),” which will be held from 8:30-10 a.m. Oct. 22 at the AAP National Conference & Exhibition.

The session will be led by Grant Mussman, M.D., FAAP, and Jeffrey Bennett, M.D., M.B.O.E., FAAP, who are involved in the AAP Stewardship in Bronchiolitis Project, a multi-centered collaboration in which community hospitals are working to improve bronchiolitis care across the patient care continuum.

One of the barriers to improving bronchiolitis management was differences in the approaches of various departments in the hospital, said Dr. Mussman, a member of the AAP Section on Hospital Medicine.  

“And all that leads to confusion on the patient’s part and on the parent’s part,” he said. “… There has to be a way to bridge those gaps and build collaborations so that we’re all on the same page in terms of our care.”

Those differences can persist even when evidence-based guidelines are available, added Dr. Bennett, a member of the Section on Hospital Medicine and the Council on Quality Improvement and Patient Safety.

“Different groups can look at the same guidelines and carry away different messages based on what drives their practice and what their daily experience is like,” Dr. Bennett said. “Collaboration would require that we work together looking at the guidelines and share how we are interpreting those recommendations in the context of our practice.”

Dr. Mussman and Dr. Bennett will describe measures, interventions and results of the bronchiolitis project. Then participants will break up into small groups to work through various scenarios, such as management of community-acquired pneumonia or pyelonephritis, using lessons learned from the bronchiolitis project. Ideally, each group would have an ED doctor, primary care physician and hospitalist.

One of the biggest lessons learned from the bronchiolitis project is the importance of involving representatives from various departments in quality improvement work, said Dr. Mussman, assistant professor of clinical pediatrics, Cincinnati Children’s Hospital.

“It’s much harder to tell somebody something. That doesn’t work very well to engage them,” he said. “But if you have co-leadership, for example, with an emergency department representative and a hospital medicine representative, then coming to a consensus on how to do improvement is much easier.”

It’s also important to emphasize that the final product is not predetermined, added Dr. Bennett, associate professor of clinical pediatrics at Kentucky Children’s Hospital/University of Kentucky.

When the focus is on the patients’ experience, quality does improve, he said.

“When the ED and inpatient settings are working from the same playbook, using the same language, the same educational tools, the patients experience not only more holistically consistent care, but they’re often experiencing much more efficient care.”

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