Secondary Logo

Abstract O-54: PERFORMANCE OF ELECTRONIC DASHBOARD IN RECOGNITION OF CLINICAL DETERIORATION IN PEDIATRIC ACUTE CARE PATIENTS

Roberts, J.1; Robinet, D.2; Yun, A.3; Whitlock, K.4; Murchie, W.5

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 23–24
doi: 10.1097/01.pcc.0000537396.60945.c2
Oral Abstracts
Free

1University of Washington/Seattle Children’s Hospital, Pediatric Critical Care, Seattle, USA

2Seattle Children’s Hospital, Clinical Information Systems, Seattle, USA

3Seattle Children’s Hospital, Enterprise Analytics, Seattle, USA

4Seattle Children’s Hospital, Center for Child Health- Behavior and Development, Seattle, USA

5Seattle Children’s Hospital, Pediatric Critical Care, Seattle, USA

Back to Top | Article Outline

Aims & Objectives:

Rapid response team (RRT) functionality requires two critical elements: early recognition of clinical decline and ability to intervene. Components of early recognition would ideally be both sensitive and specific, identifying a high proportion of declining patients, without overburdening the RRT. We evaluated the performance of an electronic system of organizing pediatric patients identified as high risk for clinical deterioration to facilitate surveillance.

Back to Top | Article Outline

Methods

Modified Pediatric Early Warning scoring (MPEWS) was performed every 4 hours within the electronic medical record. Four categories comprise patients identified as high risk and present on the electronic dashboard: 1) MPEWS score > 5 in first 24 hours of admission, 2) MPEWS > upper confidence interval from patient baseline after 24 hours, 3) previous RRT, and 4) staff concern.

Back to Top | Article Outline

Results

From 10-1-2015 to 6-30-17, 920 patients transferred from acute care to ICU and 795 (86%) were identified on the electronic dashboard > 1hour prior to transfer. Four types of alerts contributed to the dashboard: MPEWS < 24 hours 332 (42%), MPEWS > 24 hours 94 (12%), clinical concern 220 (28%) and previous RRT 149 (19%). Patient Rescue events (ICU intervention within 2 hours of transfer to the ICU) occurred in 101 patients. Of these, 86 (85%) were present on dashboard.

Back to Top | Article Outline

Conclusions

Our electronic system to organize surveillance correctly identifies most of the patients within 1 hour prior to the transfer. The occurrence of patient Rescue events, despite the ability to accurately identify the patients, suggests that the ability to quickly intervene is an area for improvement.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies