Overview

The clinical pathways instituted at the Children's Hospital and Health Center of San Diego (CHSD) in the 1990s have become the integrated pediatric health care system's operational backbone. CHSD's standardized processes of care reduced lengths of stay, increased the health system's organizational capacity, and attracted business. Although these outcomes lowered the cost of providing care, the financial benefits have accrued mostly to insurers and other payers. Because children's hospitals are typically paid on a per diem basis, CHSD is currently working to establish new partnering business models and payment methodologies that would enable it to share in the cost savings. It also has begun rolling out a computerized, physician order entry system designed to reduce medication errors.

For more information, see the Fund publication under Related Resources.

This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Fund-sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied organizations' experiences in ways that may aid their own efforts to become high performers. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case studies series is not an endorsement by the Fund for receipt of health care from the institution.