Identifying Hospitals With High Performance in Pediatric Safety for All Children

INTRODUCTION. Adverse safety events cause significant morbidity and mortality. The Agency for Healthcare Research and Quality’s (AHRQ) seven pediatric-specific quality indicators (termed PDIs) measure severe and preventable adverse outcomes. We previously demonstrated that PDI safety events disproportionately impact Black and Hispanic patients and that these disparities vary across hospitals. Positive deviance methods propose studying high performing hospitals to identify interventions that may improve care broadly. Our goal was to adapt methods used by the Centers for Medicare and Medicaid Services (CMS) to identify hospitals that excel in pediatric safety equity defined as achieving both high overall safety and low disparities. Future studies of high-performing hospitals will explore potential best practices for advancing equity in pediatric safety.