Maintenance of Certification (MOC) Portfolio Program Active Projects

The Children’s Health℠ Maintenance of Certification (MOC) Portfolio Program maintains a list of projects available for participation credit. For additional information about a project, please contact the MOC Portfolio Program.

Participate in a MOC-Approved Project

• Step 1: Select a project and reach out to project lead.

• Step 2: Complete participation criteria.

• Step 3: Submit a Participation Form (pdf) to the project lead for signature. Then, submit signed Participation form to MOCProgram@childrens.com

• Step 4: MOC Program will submit the participation form directly to ABMS. Credit will be issued within 30 days.

Active Projects

Fibrinogen Concentrate for the Correction of Hypofibrinogenemia after Cardiopulmonary Bypass

Project Leader: David Preston
Board: Anesthesiology
Project Summary: Acquired hypofibrinogenemia in children after cardiopulmonary bypass (CPB) contributes to impaired coagulation, which may exacerbate perioperative bleeding and subsequent blood product exposure. Available products recommended for perioperative fibrinogen replacement in pediatric cardiac surgery include cryoprecipitate as well as fibrinogen concentrate. Synthetic products such as fibrinogen concentrate have the benefit of reducing allogeneic blood product exposure while minimizing the potential for excessive hemodilution and transfusion related circulatory overload. Considering these benefits, our group developed a formalized protocol for the intraoperative utilization of fibrinogen concentrate for populations most vulnerable to the consequences of transfusion related circulatory overload and allogeneic blood product exposure after CPB. These populations are neonates, single ventricle pathway patients, ventricular assist device (VAD) recipients, and heart transplant recipients.

Medical Readiness Pulled Flow

Project Leader: Danna Qunibi
Board: Pediatrics
Project Summary: The project aimed to utilize the A3 lean framework and Lean Six. Sigma (LSS) principles to improve the patient discharge process THROUGHOUT THE CHILDRENS HOSPITAL IN DALLAS AND PLANO. CURRENT SERVICES INCLUDE GASTROENTEROLOGY, PULMONARY, HOSPITALIST MEDICINE IN PLANO, NICU, CARDIOLOGY/HEART CENTER with an emphasis on medical readiness. With medical readiness as a trigger for discharge order placement, the result can be an equalization of percentage of discharge orders placed throughout the day (continuous flow rather than batching of discharges after rounds) A series of assessments and interventions driven by the A3 lean framework and LSS principles over a 12-18 month period.

Decreasing Rejection within First Year for Kidney Transplant Patients

Project Leader: Mouin Seikaly
Board: Pediatrics
Project Summary: The kidney transplant team identified a cluster of patients in the Summer of 2023 (N=8)* that had renal allograft rejection. A work group was put together to investigate the root cause(s) and characterize commonality among identified cases. *During this investigation, an additional cluster of patients (n=5) were identified for a new total of 13.

Home Medication Reconciliation Upon Admission

Project Leader: Clifford Chen
Board: Emergency Medicine, Family Medicine, Internal Medicine, Pediatrics
Project Summary: Home Medication reconciliation (HMR) is the process of identifying, entering, and acting on patient home medications. The purpose of HMR is to identify and resolve discrepancies on home medication and those newly ordered medications. As one of the leading causes of medication errors in the hospital, these can lead to adverse drug events in the hospital, patient dissatisfaction for inaccurate records and affect patient outcomes. Joint Commission has listed the medication reconciliation as a National Patient Safety Goals for Hospitals.​  

Discharge Milestones Readiness

Project Leader: Abiara Agwu
Board: Pediatrics
Project Summary: During this stage of the project, patients with a projected discharge within 12 hours are identified by the attending physician or the resident team by clicking the "Discharge within 12 hours" button found within the Discharge Milestones tab in the EMR (EPIC). Early identification of patient's improve discharge planning and improve discharge efficiency. Additionally, individuals in the PHM division have used this data to better plan for prospective admissions including bed and team assignments.

Improving Access to Neonatal Care Level Four (PRANCER)

Project Leader: Danna Qunibi
Board: Pediatrics
Project Summary: The project aimed to utilize the A3 lean framework and Lean Six Sigma (LSS) principles to improve the patient discharge process on a gastroenterology (GI) floor with an emphasis on medical readiness. With medical readiness as a trigger for discharge order placement, the result can be an equalization of percentage of discharge orders placed throughout the day (continuous flow rather than batching of discharges after rounds) A series of assessments and interventions driven by the A3 lean framework and LSS principles over a 12-month period.

Heart Failure 30 Day Readmission Reduction

Project Leader: Ryan Butts  
Board: Pediatrics
Project Summary: The project utilized evidence-based practices to reduce 30 day readmission rate after acute heart failure admission from 20% to 10%.

Optimizing Non-Invasive Respiratory Support Using Multi Step Simulation Training

Project Leader: Venkatakrishna Kakkilaya  
Board: Pediatrics
Project Summary: Starting June 2021, we have implemented strategies to decrease intubation rate of infants ≤25 weeks GA with a new simulation-based QI project emphasizing steps to optimize face mask positive pressure in the DR. This has led to decrease in the intubation rates from 34% to 28%. Overall, the need for mechanical ventilation has decreased from 77% to 39% after successful implementation of QI projects.

PAC3 Hearts To Home

Project Leader: Sonali Patel
Board: Pediatrics
Project Summary: Improve acute care cardiology discharge outcomes and experience for the patient, family, clinical team and hospital system.

Decreasing Critical and Severe Sepsis Mortality in Pediatric Patients

Project Leader: Brian Wagers
Board: Pediatrics
Project Summary: To reduce sepsis mortality at Children’s Health to zero. We improve our processes so much that we eliminate preventable sepsis mortalities for our patients. We want to improve our recognition of sepsis to the point where we do not miss a child who develops sepsis in our system or comes to our emergency department with sepsis. We want to improve our treatment, in accordance with national/international guidelines to provide the appropriate treatment in the time periods specified by these guidelines.

Systematic Screening of Social Determinants of Health  

Project Leader: Stormee Williams
Board: Pediatrics
Project Summary: At Children's Health, we screen our patient families for health literacy, social support, food insecurity, transportation and housing. Each of these can influence a patient's access to care and, ultimately, the outcomes of the care they experience. Screening for SDOH is one way we can work to address the unique needs of our patients and reduce healthcare disparities.

Anesthesiology Department Enhanced Recovery After Surgery (ERAS) Project

Project Leader: Katie Liu
Board: Anesthesiology
Project Summary: Improve usage of Anesthesia Enhanced Recovery after Surgery (ERAS) protocols.

Promoting cefazolin use in all Penicillin Allergic Patient  

Project Leader: Hadi Sakhai
Board: Anesthesiology, Pediatrics, Surgery
Project Summary: Safer patient care through appropriate use of cefazolin instead of clindamycin in penicillin allergic patients.

Behavioral Health Innovation and Guidance: Provider Advisory Group

Project Leader: Sabrina Browne
Board: Family Medicine, Pediatrics
Project Summary: The Provider Advisory Group (PAG) will vet the quality of computer‐based trainings, participating in case studies and smaller focus groups, identifying gaps in training material, and assisting in development of evaluations and practice readiness assessments to address treatment of lower‐acuity mental and behavioral health issues in the Primary Care setting.

Implementing Safe and Targeted Care for Children with Musculoskeletal Infection through Appropriate Work-Up and Treatment

Project Leader: Lawson Copley
Board: Pediatrics, Radiology, Anesthesiology, Emergency Medicine, Surgery
Project Summary: Providing consistent and efficient evidence-based care for children with deep musculoskeletal infection by obtaining appropriate initial work-up to determine correct diagnosis that will guide the decisions for implementing safe and targeted treatment.

Antimicrobial Stewardship Program (ASP)

Project Leader: Jeffrey S Kahn
Board: Pediatrics  
Project Summary: The ASP committee serves to develop, lead, implement, and monitor the appropriate use of antimicrobial therapy across all institutions within the system to improve the provision of antimicrobial therapy and maintain the core elements as delineated by regulatory and national guidelines.

Peri-Transplant Flight Plan and Huddle

Project Leader: Ryan Butts
Board: Pediatrics  
Project Summary: Improve one-year graft survival (12-month rolling total) while increasing Discharge Survival.

Improved Efficiency and Efficacy of Care for Children with Deep Musculoskeletal Infection who are treated by a Multi-Disciplinary Team

Project Leader: Lawson A. B. Copley
Board: Anesthesiology, Emergency Medicine, Orthopaedic Surgery, Pediatrics, Radiology
Project Summary: The Multidisciplinary team applies evidence-based clinical guidelines to improve the care of children with musculoskeletal infections, including length of hospitalization and readmission rates.

Pediatric Hematology/Oncology Central Line Associate Blood Stream Infection Reduction  

Project Leader: Victor Aquino
Board: Pediatrics
Project Summary: Local implementation of the CLABSI bundles in the Pediatric Hematology/Oncology unit with the specific goals of reducing the rate of central line infections and increasing reliability of the maintenance bundles.

Implementing Evidence-Based Practice Guidelines for the Management of Bronchiolitis

Project Leader: Vineeta Mittal
Board: Pediatrics
Project Summary: The objective for the next 12 months starting 1/1/2024 is to decrease the need for MV within 72 hours by 10% from 39% to 30%