AnnualReport2020

Recently, Enrique Garavito Salazar, M.D., plastic and reconstructive surgeon at the Mexico Shriners Hospital, and his team began using laser therapy to treat burn scars. Since September 2018, more than 200 patients with multiples scars have benefited from this treatment. The fractional CO2 laser system fires a laser beam that splits into numbers of microscopic beams, producing tiny dot or fractional treatment zones within the selected target area only. Therefore, the heat of the laser only passes deeply through the fractional damage area. This allows the skin to heal much faster than if the whole area was treated. During the skin self-resurfacing, a great amount of collagen is produced for skin rejuvenation. Eventually the skin will look much healthier. Almost all laser therapy requires repeated treatment to achieve the desired effect. Treatments are scheduled several weeks apart. The laser therapy application is limited to post-burn scarring, including hypertrophic or hyper- pigmented scars and keloids and other forms of skin discoloration, especially redness. It can also be used to decrease pruritus (intense itching). Shriners Hospitals for Children — Mexico is pleased to be able to offer this advanced treatment to its patients. The treatment method is also offered at other locations in our health care system. Improving Orthotics and Prosthetics Delivery Pediatric Orthotic and Prosthetic Services Inc. aka POPS, (an LLC solely owned and controlled by Shriners Hospitals

supplies, adjustments and repairs made to existing devices. In 2019, POPS consolidated its six central fabrication (C-Fab) locations. Now there are two sites efficiently serving our patients’ needs. C-Fab West (which was one of the original centers) is located within our Portland hospital and the other, C-Fab East, is a brand new state-of-the art facility in Tampa, Florida. These two facilities fabricate most of the custom devices for all U.S. Shriners Hospitals health care and POPS locations. POPS leads the country in utilization of Computer Aided Design (CAD) for both orthotics and prosthetics. Measuring and Tracking Clinical Outcomes Makes a Difference Measuring, reporting and comparing health care outcomes is essential to improving patient experience, improving the health of populations, and delivering the highest quality care. Shriners Hospitals for Children has a three-pronged approach to capturing clinical outcomes: 1. We capture patient-reported outcomes, or outcomes reported directly from the patient on their health-related quality of life in the areas of pain intensity, pain interference, relationships with peers and mobility. 2. We capture and report functional outcomes, or outcomes measured by a clinician that measure functional improvements over time, e.g. gains made by the patient in walking independently. 3. We also measure and report quality and safety metrics such as surgical site infection and readmission so that we can identify strengths and drive improvement processes. Patient Reported Outcomes Measurement Information System (PROMIS®)

Shriners Hospitals for Children has collected over 130,000 PROMIS® assessments, making us one of the largest repositories of pediatric PROMIS data. Our clinicians use this information in real-time as a clinical decision support tool and we are able to aggregate the data for reporting and analytical purposes. National Anesthesia Clinical Outcomes Registry (NACOR) In early 2019, Shriners Hospitals for Children began reporting data to the National Anesthesia Clinical Outcomes Registry (NACOR). NACOR is a data warehouse housed by the Anesthesia Quality Institute (AQI) and developed by the American Society of Anesthesiologists (ASA). Some of the information reported includes total cases, provider ID, ASA physical status, payment type, case duration, age, sex, and adverse outcome (if indicated). In 2019, we reported data on over 12,000 anesthesia cases. With millions of cases in the registry, AQI’s clinical data provides an evidence-based rationale that informs treatment choices and helps control treatment costs. NACOR is enthusiastically endorsed by the Shriners Anesthesia Executive Council (AEC), Quality & Safety Council, and Physician Executive Team. Participating in the registry provides Shriners Hospitals for Children the following benefits: • A ccess to patient care management tools, education, and IT vendors • N ational performance indicators • C ustom continuous performance monitors • A bility to measure performance beyond local facility • P erformance gap analysis and patient outlier identification • N ational comparative analytic reports • P eer-to-peer benchmarks

for Children) accomplished a great deal in

2019. POPS provided 52,683 orthotic devices and 2,349 prosthetic devices to patients receiving care in our U.S. health care facilities. These numbers do not include the thousands of

Since we began electronically collecting patient-reported outcomes (PRO) data in 2016,

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