Texas Children’s EBOC play crucial role in developing clinical standards, enhancing outcomes

September 12, 2017

A 4-year-old child undergoes a Fontan procedure to correct a heart problem. The child’s medical team is unaware that the proposed post-surgical plan of care may endanger not only the patient but also the patient’s family – and is also financially wasteful. If the care team is unaware of these potential risks, how can they offer the patient and patient’s family the best, most appropriate care that yields the best possible outcomes?

As one of the top five pediatric hospitals in the country, Texas Children’s cares for many patients with a number of medical conditions. Across our hospital system, care teams follow clinical standards related to specific medical conditions to ensure the best care is delivered to the right patient at the right time, leading to improved long-term outcomes.

“Clinical standards provide a way to align our clinicians, families and other organizations with a more streamlined approach to improve the safety, quality and cost efficiency in the delivery of patient care,” said Dr. Charles Macias, chief clinical systems integration officer at Texas Children’s and director of the Center for Clinical Effectiveness and Evidence Based Outcomes Center. “By allowing this type of standardization, hospitals can minimize wasteful expenditures caused by medical errors and ordering of unnecessary tests which can lead to inefficiencies in health care.”

From developing patient care guidelines for post-surgical care to treating common conditions like asthma and diabetes – among many other clinical conditions – our health care teams rely heavily on the instrumental work of Texas Children’s Evidence Based Outcomes Center (EBOC). The team reviews and translates scientific evidence into clinical standards that detail the essential steps in the care of patients with a particular clinical condition.

“Once a specific disease is selected, our team conducts a thorough review of evidence using the GRADE methodology,” said EBOC Research Specialist Andrea Jackson. “We review clinical questions and assess potential benefits and harms of different treatment options. We guide multidisciplinary teams to incorporate clinical expertise from our physician and nursing partners as well as input from patient family advocates on their own experiences into the development of practice recommendations based on available evidence regarding the specific clinical condition.”

Since the opening of the EBOC in 2010, the team has developed 95 clinical standards, some of which have led to publications in peer-reviewed health journals. In addition to the Connect website, Texas Children’s clinical standards for medical conditions are available here on the Outcomes and Safety external site.

“We are adding new clinical standards to that site about every three months,” said Anne Dykes, assistant director of Texas Children’s Outcomes and Impact Service. “All 10 years’ worth of work that we’ve built internally to help our own clinicians and those across our system, we’re now making available to the public. These standards are not just for physicians, clinicians and administrators at other hospitals, but also for patient families to help them understand the essential steps in the care of patients with a particular condition.”

The center also provides an evidence-based practice course that has educated more than 150 health care professionals on how to develop practice guidelines. Since 2007, more than 300 physicians, 275 nurses along with many of our patient family advocates have participated in guideline developments to enhance patient outcomes.

Additionally, the EBOC has launched a national collaborative with 11 other children’s hospitals to bring clinical standardization across the nation.

“Through this strategic collaboration, we are identifying where clinical standards could be done in unison so that we could all share in our products and still offer an opportunity to tailor them to our own individual institutions,” Macias said. “We have a national need for the science of it and a local need for the process of care delivery.”

Click here for a complete list of the EBOC’s 95 clinical guidelines developed to treat specific medical conditions.