September 5, 2003

Shmerling to co-chair national child health accountability initiative

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Jim Shmerling

Shmerling to co-chair national child health accountability initiative

Jim Shmerling, CEO of Vanderbilt Children’s Hospital, was recently selected to co-chair the Child Health Accountability Initiative (CHAI). CHAI is a collaboration of about two dozen of the most preeminent children’s hospitals in the country. The initiative is centered upon developing measures of quality and safety that apply directly to the care of children in hospitals.

The CHAI has a history of improving quality by selecting problem areas specific to caring for children, then coming up with a system to rapidly improve the quality of care in those areas. For example, CHAI has already come up with ways to rapidly rework a hospital’s system of providing medications to avoid errors.

“Now we’re taking the next step,” said Shmerling, who will share duties with co-chair Jim Anderson, CEO of Cincinnati Children’s Medical Center. “CHAI is designing, evaluating and implementing national measures of quality of care and health outcomes for children.”

Those standards would be adopted by inspection groups like Joint Commission on Accreditation of Healthcare Organizations, a leading organization specializing in inspecting and certifying hospitals. The first standards, which should be adopted by JCAHO this fall, apply to hospital care of children with asthma.

“But those inspections aren’t always a good fit for children’s hospitals,” said Shmerling. “Typically the focus is on adult care so they inspect children’s hospitals using measures of quality that aren’t always relevant to the care of children. We have to reply to questions like how many C-sections do we do every year, or what is the rate of complications in coronary bypass surgery. We don’t do either of those things.”

The CHAI also is looking at a system for providing the safest care for children. Currently there are few states that mandate which children must go to a hospital specializing in pediatrics, and while the science exists to say who should be treated where, no one has put that information into a set of standards yet. The CHAI hopes to set those standards.