Cargando…

Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care

INTRODUCTION: Intrahospital transports (IHTs) are high-risk activities with the potential for adverse outcomes. Suboptimal care of a patient in our emergency department (ED) needing IHT to the pediatric intensive care unit (ICU) identified improvement opportunities. We describe implementing a novel...

Descripción completa

Detalles Bibliográficos
Autores principales: Venn, April M.-R., Sotomayor, Cecilia A., Godambe, Sandip A., Vazifedan, Turaj, Jennings, Andrea D., Qureshi, Faiqa A., Mullan, Paul C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225371/
https://www.ncbi.nlm.nih.gov/pubmed/34235354
http://dx.doi.org/10.1097/pq9.0000000000000426
_version_ 1783712075861721088
author Venn, April M.-R.
Sotomayor, Cecilia A.
Godambe, Sandip A.
Vazifedan, Turaj
Jennings, Andrea D.
Qureshi, Faiqa A.
Mullan, Paul C.
author_facet Venn, April M.-R.
Sotomayor, Cecilia A.
Godambe, Sandip A.
Vazifedan, Turaj
Jennings, Andrea D.
Qureshi, Faiqa A.
Mullan, Paul C.
author_sort Venn, April M.-R.
collection PubMed
description INTRODUCTION: Intrahospital transports (IHTs) are high-risk activities with the potential for adverse outcomes. Suboptimal care of a patient in our emergency department (ED) needing IHT to the pediatric intensive care unit (ICU) identified improvement opportunities. We describe implementing a novel checklist (Briefing ED-to-ICU Transport To Exit Ready: BETTER) for improving the IHT safety of pediatric ED patients admitted to the pediatric ICU. METHODS: A multidisciplinary team used the Model for Improvement to create a key driver diagram and process map. An evidence-based IHT checklist was implemented on July 23, 2019 after multiple plan-do-study-act checklist revisions. The specific aim was a ≥80% checklist completion rate for 6 months and maintaining that rate for 6 months. An anonymous, voluntary survey of ED nurses and physicians, 9 months postimplementation, evaluated perceived improvements in IHT safety. The outcome measure was the proportion of IHT-related incident reports, per ED-to-pediatric ICU admission, comparing baseline (2-year preimplementation) and intervention (1-year postimplementation) periods. Balancing measures included a quantitative assessment for any throughput measure delays and a survey question on perceived delays. RESULTS: From July 23, 2019 to July 22, 2020, 335 (84%) of 400 ED-to-ICU admissions had completed IHT checklists. Ninety percent of survey respondents (84% response rate) agreed that the checklist improved IHT safety. The incident report rate was lower in the intervention period (0.5% versus 2.3%; P = 0.03), with special cause improvement on T-chart analysis. Balancing measures did not indicate any delays secondary to checklist implementation. CONCLUSIONS: This IHT checklist was feasible and associated with improvements in perceived safety and incident event reporting. Further studies are needed to assess generalizability.
format Online
Article
Text
id pubmed-8225371
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-82253712021-07-06 Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care Venn, April M.-R. Sotomayor, Cecilia A. Godambe, Sandip A. Vazifedan, Turaj Jennings, Andrea D. Qureshi, Faiqa A. Mullan, Paul C. Pediatr Qual Saf Individual QI projects from single institutions INTRODUCTION: Intrahospital transports (IHTs) are high-risk activities with the potential for adverse outcomes. Suboptimal care of a patient in our emergency department (ED) needing IHT to the pediatric intensive care unit (ICU) identified improvement opportunities. We describe implementing a novel checklist (Briefing ED-to-ICU Transport To Exit Ready: BETTER) for improving the IHT safety of pediatric ED patients admitted to the pediatric ICU. METHODS: A multidisciplinary team used the Model for Improvement to create a key driver diagram and process map. An evidence-based IHT checklist was implemented on July 23, 2019 after multiple plan-do-study-act checklist revisions. The specific aim was a ≥80% checklist completion rate for 6 months and maintaining that rate for 6 months. An anonymous, voluntary survey of ED nurses and physicians, 9 months postimplementation, evaluated perceived improvements in IHT safety. The outcome measure was the proportion of IHT-related incident reports, per ED-to-pediatric ICU admission, comparing baseline (2-year preimplementation) and intervention (1-year postimplementation) periods. Balancing measures included a quantitative assessment for any throughput measure delays and a survey question on perceived delays. RESULTS: From July 23, 2019 to July 22, 2020, 335 (84%) of 400 ED-to-ICU admissions had completed IHT checklists. Ninety percent of survey respondents (84% response rate) agreed that the checklist improved IHT safety. The incident report rate was lower in the intervention period (0.5% versus 2.3%; P = 0.03), with special cause improvement on T-chart analysis. Balancing measures did not indicate any delays secondary to checklist implementation. CONCLUSIONS: This IHT checklist was feasible and associated with improvements in perceived safety and incident event reporting. Further studies are needed to assess generalizability. Lippincott Williams & Wilkins 2021-06-23 /pmc/articles/PMC8225371/ /pubmed/34235354 http://dx.doi.org/10.1097/pq9.0000000000000426 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Individual QI projects from single institutions
Venn, April M.-R.
Sotomayor, Cecilia A.
Godambe, Sandip A.
Vazifedan, Turaj
Jennings, Andrea D.
Qureshi, Faiqa A.
Mullan, Paul C.
Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care
title Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care
title_full Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care
title_fullStr Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care
title_full_unstemmed Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care
title_short Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care
title_sort implementation of an intrahospital transport checklist for emergency department admissions to intensive care
topic Individual QI projects from single institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225371/
https://www.ncbi.nlm.nih.gov/pubmed/34235354
http://dx.doi.org/10.1097/pq9.0000000000000426
work_keys_str_mv AT vennaprilmr implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare
AT sotomayorceciliaa implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare
AT godambesandipa implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare
AT vazifedanturaj implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare
AT jenningsandread implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare
AT qureshifaiqaa implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare
AT mullanpaulc implementationofanintrahospitaltransportchecklistforemergencydepartmentadmissionstointensivecare