Top 3 quality improvement initiatives for pediatric hospitals

Quality management processes have been used in hospitals for years.  Most hospital systems employ a quality manager to oversee departments, or entire hospital systems, to ensure there is continuous improvement.  Hospitals regularly use Lean methodologies to eliminate waste and process inefficiency.

Due to their sensitive nature, pediatric hospitals often go above and beyond the standard QA methods and look to employ an extra layer of safety and reliability.  QA managers can’t easily implement a new process independently; they must submit the proposed change for analysis by a safety board.  The number #1 priority must always be patient safety, so these types of checks and balances help prevent unintended consequences.

Children’s hospitals often push the boundaries when it comes to innovation.  The Children’s Hospital of Philadelphia (CHOP) explains healthcare quality and process improvement as “a unique field of scientific inquiry that requires multidisciplinary collaboration among experts trained in medicine, behavioral sciences, epidemiology, economics, and business processes.” Implementing quality improvement initiatives correctly can impact clinical decisions, medication safety, treatment adherence, and protect patients’ private health data.

There are hundred’s of quality management processes that hospitals can use to effect positive change.  Of those, some stand out above the rest.  Below are three quality management tools that pediatric hospitals can use to gain an advantage in continuously improving their healthcare outcomes.

child pediatric hospital

6S Initiatives

6S is an extension of the 5S process commonly used in quality improvement projects.  5S stands for Sort, Straighten, Shine, Standardize, and Sustain.  5S is a pre-defined way to analyze the location, quality, maintenance, use, and condition of healthcare tools in a hospital.  6S adds an additional element to the five established methods, safety.  Safety is the critical element of implementation in a children’s hospital, so more time is devoted to this element than any other.

Under the safety protocol, more time is spent looking at procedures, equipment, best practices, and policies to ensure they meet the standards of the department, hospital, and regulatory bodies.  This is implemented as the final step once Sort, Straighten, Shine, Standardize, and Sustain have been completed.  It allows the quality manager to analyze the finished product and report on the safety improvements.


What is Kaizen?  Kaizen is a Japanese word that means Change for the Good.  In short, it is a term used today for Continuous Improvement.  Kaizen eliminates waste by removing Non-Value-Adding Activities, resulting in improved standardized systems, efficiency, processes, quality, delivery, service, and cost savings. 

Kaizen projects are short-duration improvement sprints that typically last one to two weeks.  They use Lean Six Sigma principles to improve processes on a micro-level.  They are usually designed to fix a small inefficiency.  A good example in healthcare would be delayed patient admissions due to paperwork.  This problem is significant in pediatrics since delayed access could have dire consequences for younger patients.

Training staff in Kaizen project execution and Lean Six Sigma allows them to use processes like Plan-Do-Check-Act (PDCA) and Critical Path Analysis to improve patient outcomes.

Change Management

A strong focus on management can lead to excess bureaucracy in a hospital.  Finding ways to eliminate it is difficult but possible with proper tools.  Fixing problems within a hospital means change, and as a general rule, people are not good with change.  Having a good Change Manager with a proper change management plan in place is vital in pediatric medicine.  Change managers can work with stakeholders of the hospital (Both internal like doctors and external like patients) to ensure new processes are understood and implemented smoothly.  Change management is all about communication, so think of this position as the chief communications officer, disseminating information quickly and accurately.

The infographic below shows how bureaucracy leads to resistance to change.  Children’s hospitals need a culture of cooperation to ensure change is managed properly and that there is buy-in across the organization, it’s doctors, nurses, and patients.