Cincinnati Children's Hospital: Learning networks
The Learning Networks Program at Cincinnati Children’s has developed and supports several highly successful multisite, practice based clinical networks that use data for research and improvement.
Due to the relatively small number of patient groups in paediatrics, the need to share learning and possibly resources across sites is even more critical. Individual organisations do not have enough patients to generate adequate sample sizes to produce generalizable knowledge (Forrest et al., 2014). Learning Networks combine data and ideas across multiple sites and engage patients, families, clinicians and scientists in co-producing measurably improved outcomes.
Learning Networks at Cincinnati Children’s can trace their origin back to the Institute of Healthcare Improvement’s Breakthrough Series, established in 1995, which were short term (6 to 15 month) learning systems. They aimed to help health care organisations make breakthrough improvements in quality while reducing costs. Through this experience, Cincinnati Children’s learnt that it takes time to develop a foundation for improvement and to have an impact on systems of care for children and families. In 2002 the American Board of Paediatrics introduced a requirement for paediatricians to be involved in quality improvement project to qualify, namely the performance in practice component of the Maintenance of Certification requirements for paediatricians. The Board provided initial funding for the learning networks, and helped determine what quality improvement criteria should be included. The first network established focused on inflammatory bowel disease and initially involved seven hospitals, it has since risen to over 90 hospitals spanning 3 continents.
Cincinnati-associated networks are supported in two main ways; either through a top-down approach (e.g. government or foundation grant used to hire Cincinnati services), or through a more grassroots effort (e.g. member hospitals each pay participation fees to cover administrative costs).