Harmonizing Care: Decreasing Unnecessary Variation in Care

Decreasing unnecessary variation in care has been extremely important to best outcomes. We learn from each other and alter care as a network.

What is the project focus?

Variation in Stroke Rates Across Children's Hospitals
Figure 1: Extreme variability in the rates of stroke amongst U.S. Pediatric hospitals.

ACTION created a Harmonization Committee to gather consensus and develop best practice protocols and guidelines for VAD and heart failure care. Early on, we identified that variation in care and outcomes exists across ACTION sites. For example, there is a significant amount of variation in stroke rates between institutions (See Figure 1)

This variation is thought to be driven by center volume and experience. This suggests that there is an opportunity to identify and implement best practices from those centers that have lower stroke rates, in order to improve the outcomes for children treated at all centers. 

Although initially, we focused on decreasing stroke rates by standardizing care, we have expanded our quality improvement work to include other aspects of acute heart failure.

Protocols and guidelines are collected from ACTION sites and consensus is combined to create an ACTION Harmonized Protocol or Guideline. 

Who is impacted?

ACTION clinician members can access all harmonized protocols and guidelines to help shape their institutional practices and improve care delivery through use of consensus best practices.

What are we doing to help?

For a list of all our current Harmonized Protocols, see our Publications Page.

Providers: To download our Harmonized Protocols please login to (or sign up for) My ACTIONEducation, and visit the ACTION Library > Resources.