The goal of C4-MNP pilot testing was to implement benchmarking of quality measures in 15 units (acute care and intensive care) across 9 pediatric cardiovascular programs in free-standing children’s hospitals. The complete set of 10 measures was tested at participating pilot sites. Nursing representatives from each site led the implementation of the measures and data collection at their site. Site representatives entered their data into a limited-access database designed for the C4-MNP project using REDCap, a secure electronic data capture software at Boston Children’s Hospital.

Pilot testing of 10 quality measures

The 10 quality measures that met criteria for pilot testing across freestanding children’s hospitals were implemented in 9 C4-MNP collaborating centers over the course of a six-month pilot testing phase that began in January 2016. Sites were selected based on their available resources to support data collection, and their ongoing participation in the Children’s Hospital Association Pediatric Health Information System (PHIS).

Pilot testing concluded in September 2016. Dissemination of the pilot testing data is underway. Variation in nursing workforce characteristics were reported across pilot sites, including the proportion of registered nurses (RNs) with 0-2 years of experience, the proportion of RNs with a Bachelor of Science in Nursing, and the proportion of RNs with certification. For detailed results, please review the C4-MNP Phase III Aggregate Result Report.

Quality measure feasibility and usability were also assessed at the conclusion of pilot testing. With the exception of pain score reduction, all pilot measures were deemed feasible to implement. Eight of the ten measures received a score of ≥75% for their ability to be used for internal quality improvement; confirming, changing, or standardizing practice; increasing efficiency; and improving patient outcomes. For detailed results, please review the C4-MNP Phase III Measure Feasibility and Usability Aggregate Result Report.

Results from this work will support initial development of benchmarks and evaluation of the association of the quality measures with patient outcomes.

For a list of the quality measures tested and detailed measurement plans, navigate to Quality Measures.

Benchmarking nursing structure measures

C4-MNP centers have endorsed annual data collection and benchmarking for four nursing workforce structure measures (BSN Education, Years of Experience, Nursing Certification, and Health of the Work Environment). Development of the annual measurement and benchmarking process is underway, and will launch in 2020.

Below are the 10 quality measures pilot-tested in 2016. Click on the measure to view detailed measurement plans.

Structure measures

1. Health of the work environment
2. Overall years of nursing experience
3. Bachelor of science in nursing (BSN) education
4. Nursing certification
5. Nursing staff turnover

Clinical measures

6. Weight gain within 72 hours of discharge
7. Feeding safety
8. Utilization of early warning scores
9. Pain scores decreased within 60 minutes
10. Device-related pressure ulcers