A loss of a peripheral IV on the acute care unit and a need for replacement is traumatic for pediatric patients and infiltrated IV lines are a risk for hospital acquired injury.  IV replacement is also a resource and time intensive process for our unit.  Evidence shows that variability in practices around IV line mainenance can also lead to IV fluid and other resource overuse and waste without benefitting patients.

1. What is the problem?  --- Inefficient patient tracking tool that is not integrated with the EHR and limits the growth of a program exhibiting beneficial patient outcomes 
2. What would you like to do about it? ---- Integrate a program-specific workflow into the EHR to efficiently manage patient care and accommodate program growth   
3. Team

Hearing loss is the most common neonatal sensory disorder in the United States, impacting 1.6 per 1000 births¹. While universal newborn screening in the United States has improved rates of identification, intervention, there remain significant disparities in detection in communities of color, the un/underinsured, children who live at or near the poverty line, those who reside in rural settings, and families with lower English fluency.^2,3,4

At UCSF Health Zero Harm is a strategic area of focus, and as such, solutions to combat harm events must be successfully implemented and operationally sustained. CAUTI rate and events in FY21 are significantly higher than FY20, with projections estimating an increase of 65%. UCSF’s CAUTI rates are also among the highest when compared to other UC system organizations.Current strategies to reduce catheter use and dwell time have made nominal strides to reducing CAUTI rates, resulting in continued opportunities to optimize CAUTI reduction efforts.

The Problem: The Division of Developmental Medicine within Pediatrics sees patients with complex medical and neurodevelopmental challenges. There is high demand for our small team: current waitlists are over four months for most providers; for some providers, waitlists are over 12 months. Earlier diagnosis and service initiation is associated with better outcomes for children with developmental delays or neurodevelopmental conditions, so these delays pose significant risks for the health and wellbeing of our patients.

Patients with sickle cell disease (SCD) experience lengthy, intensive hospitalizations characterized by multiple specialist involvement, high opioid administration, and both patient and provider frustration. Patients with SCD represent vulnerable and minority patient populations at UCSF, are heavily stigmatized, and the approach to managing pain lacks clear standardization with variability in providers leading to disparate outcomes.

Isolation from loved ones can create loneliness and become a hinderance to healing. The COVID pandemic forced strict visitor restrictions in our hospitals and isolated hundreds of patients from loved ones.

It is difficult to imagine a more significant issue in the long term health and well-being of our patients than the gaps in their understanding and advocacy of their care. These gaps - which are often born from systemic inequality, its socio-cultural byproducts, and the economic underpinnings that grow them - are without a doubt ambitious challenges to overcome. While some may be insurmountable for a single hospital, given that resources are frequently scarce, we believe that there are substantive ways we can bridge the most critical gaps and improve the health outcomes of our patients in real, quantifiable ways. Namely, our key focus is language access and the assistive technologies that have been shown to increase the likelihood that patients and caregivers with Limited English Proficiency (LEP) are just as involved, informed, and prepared as families with full English proficiency.

It is no secret that health disparities exist largely due to social, economic, and political reasons.  Systemic biases that perpetuate structural violence against certain groups of people due to race, class, gender, sexuality, and ability, are compounded by intersectionality, and further, still, by the current Covid-19 pandemic.  Those most affected are the most vulnerable populations, the ones who bear the heaviest of loads, with the least amount of resources to manage it.  It follows that many marginalized and historically underserved communities of color have less access...

The challenge:  Black identifying women experience unacceptably high rates of health inequity in pregnancy with higher rates of pre-term birth, cesarean sections, near death or death. This is a major public health issue as these disparities can lead to further developmental and medical complications throughout the lifespan. Additionally, Black women are more likely to report lower quality of care including discrimination which contributes to poor maternal and neonatal outcomes.