PHIS Tracheostomy Scorecard Measures Progress, Identifies Areas for Improvement

What is the Pediatric Health Information System (PHIS) Tracheostomy Scorecard, and what is its potential for improving pediatric tracheostomy care?

BOTTOM LINE

The scorecard provides a valuable framework for identifying key areas for quality improvement (QI) and shared data that can be used to compare a hospital’s performance to that of peers.

BACKGROUND: Pediatric tracheostomy admissions are associated with prolonged hospital stay, complications, and high unplanned readmission rates. The Tracheostomy Scorecard is available in the PHIS, a database developed by the Children’s Hospital Association to help compare processes, outcomes, readmissions, and costs.

STUDY DESIGN: Comparative analysis.

SETTING: Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas.

SYNOPSIS: Researchers produced a Rapid Communication Article to describe the Tracheostomy Scorecard in the PHIS. The scorecard identifies patients who underwent tracheostomy, groups them by age, categorizes them as complicated or uncomplicated, and includes measures on process, outcome, readmission, and cost. Researchers analyzed PHIS data from 2021 (comprising 943 pediatric tracheostomies) and the home institution’s data (41 pediatric tracheostomies). The resulting analysis showed comparable data usable for QI analyses. Findings revealed opportunities for QI on multiple fronts, including process measures, where hearing evaluation for patients <1 year old were below 40%. Cost measures reinforced the financial burden of tracheostomy admissions, with averages of $346,027 for uncomplicated admissions and $1.04 million for complicated admissions at peer hospitals. Authors note PHIS’ limitations, such as differences in how individual hospitals count cases and report complete data.

CITATION: Kim J, Chorney SR, Kou Y-F, et al. A pediatric tracheostomy scorecard: a quality improvement tool for comparative analysis. Laryngoscope. 2023;133:1815–1817.