Children's Hospitals Today - Fall 2024 - 25

CONNECTING / FEATURE
INNOVATION
AI use cases
Cybersecurity
Safe and ethical AI
Virtual nursing
THE HOSPITAL FOR
Sick Children in Canada and
Children's Hospital Los Angeles
are piloting generative AI in
several areas. Administrative
uses include generating
PowerPoint presentations
from Word documents or PDFs,
taking ambient notes, providing
in-basket responses, translating
discharge notes, scheduling
appointments, and delivering
items with robots. Clinical uses
include reading X-rays, training
clinical and soft skills through
simulations, supporting clinical
decisions with longitudinal
data, managing scoliosis
remotely, and updating ED
wait times. Both hospitals
emphasized the need to ensure
safety, efficiency, and ethics.
In addition to review boards
and advisory groups, hospitals
should create a secure " AI hub "
to allow safe and controlled
use of advanced AI models with
organizational data.
CYBERSECURITY THREATS
are escalating in health care.
Children's hospitals must be
ready to address and quickly
respond to incidents, including
managing a technology crisis
with incident command,
operational subgroups,
and communication. At
one children's hospital, a
cyberattack took pharmacy
claim services offline for
21 days, affecting 10,680
prescriptions. The hospital
established four workstreams
to assess the impact, including
digital technology services,
communications, clinical
operations, and finance and
revenue cycles. External
resources also helped protect
the hospital environment
and ensure continuity of
services. Despite challenges,
they achieved a 98.8%
revenue recovery due to the
team's quick decisions and
collaboration.
CHILDREN'S HOSPITAL OF
Philadelphia's governance
structure addresses three
major concerns with AI:
* Efficacy and safety, which
includes harm events and
unvalidated performance.
* Equity and bias, including
ineffective or unsafe
algorithms and products
based on assumed
or unaccounted for
differences in race, gender,
or other sociodemographic
groups.
* Ethics and privacy, which
concerns confidential
patient information and
consent.
To mitigate these risks,
the hospital created a
multidisciplinary governance
committee that reviews all
potential AI use cases, provides
comprehensive guidelines, and
offers continual education.
AKRON CHILDREN'S HOSPITAL
and Texas Children's Hospital
are using technology to bring
nurses into patient rooms
remotely. For example, virtual
nurses (VNs) can give discharge
instructions to families, freeing
up bedside nurses to provide
hands-on care. Akron Children's
partnered with a technology
vendor to introduce VNs on
a high-turnover med-surg
unit. Texas Children's started
in its NICUs and facilitated
communication using parents'
smartphones. At Akron
Children's, VNs made 163 " good
catches, " saved bedside nurses
1,300 hours, and reduced the
frequency with which nurses
skipped lunch or stayed late to
complete documentation. At
Texas Children's, VNs returned
881 hours to bedside nurses
and helped discharge patients
17% faster. Both hospitals will
expand VNs to additional
units in 2025.
Add by subtracting
MOST IMPROVEMENT INITIATIVES add something; rarely
do they subtract. Just adding things to employees' plates is a
recipe for bad friction. Leaders should consider themselves
editors-in-chief, eliminating things that frustrate and exhaust
people. Subtraction should come from the top and the bottom
and occur regularly.
WHERE TO START
Ask staff what to reduce.
Address " broken windows " -those problems
indicating no one cares.
Target unnecessary meetings and processes.
CHILDREN'S HOSPITALS TODAY Fall 2024
25
Children's Hospitals Today - Fall 2024

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