• ashirk@gmail.com
  • Kijabe, Kenya
on audits and numbers. . .

on audits and numbers. . .

Twice a year, we look at all of our numbers as a pediatrics team – every patient admitted, every outcome. What have we done well? What can we do better? How do we move forward into the next year with new goals, improved ways of doing things?

We rotate on our team who does these, and quarter 1 and quarter 2 of 2022 kids over 1 month fell to me. It was tedious but rewarding, reliving how we cared for certain patients – the kids who went home after being on blood pressure medicines and the ventilator. The kids in shock or with terrible asthma that improved. And also the kids that came too us too late or the disease was too overwhelming. . .

It is always a rollercoaster of paradox – of joy and sorrow, of life and death. . .

Below are some of the slides from my presentation – they show several things.

  1. We are busier right now than we have ever been in the history of Kijabe Pediatrics.
  2. The kids are sicker than they have ever been – we doubled our number of PICU kids and our step down monitored unit (the HDU) saw 40% of the kids we cared for.
  3. Our 24-48 hour outcomes of our sickest kids have improved as we have strengthened our emergency and critical care.
  4. Our outcomes and numbers continue to improve and our outcomes are better right now than any published outcomes in East Africa. . .

The other thing I loved looking at was how streamlined our auditing process has become. Below is the tool we use to look at every mortality and near miss to objectively see how our decision making and processes affected the outcomes. The second is one filled by our PICU nurses on accidental extubation that has led to a intubation bundle to monitor improve number of accidental extubations.

Our clinical leadership has been incredibly intentional in the last years of creating a place where we can look critically at our care, admit mistakes and areas that need improvement and move our processes forward. Our new pediatrician, Arcella, commented afterward, “I love how you do your audits. . .” She commented on their thoroughness, the feel, the transparency.

It is something I take for granted many days. Our Quality and Safety Department is active and approachable. Our administration is committed to moving things forward and changing any system that could compromise patient care. When we do well, we note it. When we can do better, we say it – and we change things.

So, for the numbers people reading, here is a glimpse of the big numbers that surround the stories of the last two posts.