I knew that I wanted to be in Boston working on QI after graduation.
My advisor suggested I use my internship as an opportunity to start building my network in Boston.
A culminating highlight of The Institute's on-campus Master of Public Health program is the opportunity for students to take what they've learned out into the field. Our internship profile series looks at how they've applied what they learned to their own interests in improving health and health care.
Allison LaRussa, MPH '17
Public Health Issue to Address:
Children in the ICU are often sedated while on a ventilator to keep them safe and comfortable. However, providers have varying perspectives regarding best practices for weaning their patients off the sedation as they prepare to remove the ventilator and get them ready to breathe on their own again. A lack of uniformity in practice can affect the quality of care that children in the ICU receive. Reducing the medication too quickly could cause withdrawal issues while delaying the weaning could lead to longer ICU stays that are unnecessary.
I worked with the Quality Improvement team in Critical Care Medicine at Boston Children’s as well as with teams of nurses and providers to assess current practices and develop improvement strategies.
We focused on assessing how well nurses and providers understand the scale they use to document and monitor patient sedation. We found there was some variation in how the scores were interpreted. We also noted that the description of the scores was often long and not always conducive for care teams to easily establish a quick check-in point on their patients. My final deliverable for this project was presenting a summary of these findings and working with the team to develop next steps for improving these monitoring tools.
I have a strong interest in quality improvement and wanted to see QI in its natural habitat, not just in a textbook. I also knew that I wanted to be in Boston working on QI after graduation. My advisor suggested I use my internship as an opportunity to start building my network in Boston. Through reaching out to QI groups in Boston and leveraging professional and alumni contacts at Boston Children’s Hospital, I connected with a QI consultant at Boston Children’s. She thought this sedation project would be a good fit.