Improving the Quality of Pediatric Healthcare through Quality Improvement Collaboratives

Opinion statement Purpose of review This review summarizes the current need for Quality Improvement Collaboratives (QICs) and includes considerations specific to pediatric healthcare, such as low-frequency of outcomes and unique funding barriers. This review will consider nuances within measure formation and data collection within QICs, available models for structured formation of a QIC, components that are integral to a QICs success, as well as lessons learned and future directions. Recent findings The literature has demonstrated an increase in the number of pediatric QI collaboratives in recent years. These collaboratives have varied in size, duration, and composition of team members. While some QICs have included members at the organizational level, others have included more novel groups such as insurance companies. Novel methodologies have also been utilized such as N of 1 trials focused on continued interventions for one patient and provider dyad. Successful QICs include use of a steering committee or pre-planning group to guide measures development, use of robust QI methodology to implement small tests of change and continuous feedback of individual and aggregate data and transparency among benchmarking sites. Ideal QI methods for use within QICs have been vetted in prior collaboratives and include formal barriers assessments using driver diagrams, PDSA cycles and analyzing data and measures using run and statistical process control (SPC) charts to inform real-time change and interventions. Summary QICs are pivotal to closing the gap in delivery of evidence based practice while minimizing widespread unnecessary practice variation across multiple organizations using available QI methodologies and tools. Novel approaches to funding such as partnership with insurance companies and educational organizations can allow for more robust participation. Future research should broaden the scope of their measures to include patient centered outcomes.