Ross E Newman1, Michael A Bingler2, Paul N Bauer3, Brian R Lee4, Keith J Mann5. 1. Department of Pediatrics, Sections of General Academic Pediatrics, renewman@cmh.edu. 2. Cardiology, and. 3. Critical Care Medicine, University of Missouri-Kansas City School of Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri; and. 4. Center for Clinical Effectiveness, Quality Improvement, Children's Mercy Hospitals and Clinics, Kansas City, Missouri. 5. Department of Pediatrics, Sections of General Academic Pediatrics.
Abstract
OBJECTIVES: To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU. METHODS: A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer). Satisfaction with the intervention and the impact of the intervention on team-based communication and resident education was collected using a retrospective pre-post survey. RESULTS: Ninety-three patients were identified as unscheduled transfers from the ward team to the ICU. Overall, 21 preintervention transfers were considered high risk, whereas only 8 patients were considered high risk after the intervention (P=.004). During the night shift, high risk transfers decreased from 8 of 17 (47%) to 3 of 21 patients (14%) (P=.03). Interprofessional communication improved with 12 of 14 nurses and 24 of 25 residents reporting effective communication after the intervention (P<.0001) compared with only 1 nurse and 15 residents reporting a positive experience before the intervention. Overall, all 3 provider groups stated an improved experience covering a high-risk cardiology patient population. CONCLUSIONS: Implementation of an interprofessional huddle may contribute to decreasing high-risk transfers to the ICU. Initiating a daily huddle was well received and allowed for open lines of communication across all provider groups.
OBJECTIVES: To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU. METHODS: A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer). Satisfaction with the intervention and the impact of the intervention on team-based communication and resident education was collected using a retrospective pre-post survey. RESULTS: Ninety-three patients were identified as unscheduled transfers from the ward team to the ICU. Overall, 21 preintervention transfers were considered high risk, whereas only 8 patients were considered high risk after the intervention (P=.004). During the night shift, high risk transfers decreased from 8 of 17 (47%) to 3 of 21 patients (14%) (P=.03). Interprofessional communication improved with 12 of 14 nurses and 24 of 25 residents reporting effective communication after the intervention (P<.0001) compared with only 1 nurse and 15 residents reporting a positive experience before the intervention. Overall, all 3 provider groups stated an improved experience covering a high-risk cardiology patient population. CONCLUSIONS: Implementation of an interprofessional huddle may contribute to decreasing high-risk transfers to the ICU. Initiating a daily huddle was well received and allowed for open lines of communication across all provider groups.
Authors: Camilla B Pimentel; A Lynn Snow; Sarah L Carnes; Nishant R Shah; Julia R Loup; Tatiana M Vallejo-Luces; Caroline Madrigal; Christine W Hartmann Journal: J Gen Intern Med Date: 2021-02-08 Impact factor: 6.473
Authors: A Lynn Snow; Julia Loup; Robert O Morgan; Kathy Richards; Patricia A Parmelee; Rosa R Baier; Ellen McCreedy; Barbara Frank; Cathie Brady; Liam Fry; Megan McCullough; Christine W Hartmann Journal: BMC Geriatr Date: 2021-04-27 Impact factor: 3.921