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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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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 |
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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 |
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