Evidence map›Paper›PMID 32426627›Full record

ArticlePediatric quality & safety

Improving Disposition Decision-Making for Pediatric Diabetic Ketoacidosis: A Quality Improvement Study.

Tara Kaushal, Katherine Lord, Robert Olsen, Sanjiv Mehta, Stephanie Clark, Benjamin Laskin, Danielle Traynor, April Taylor, Kathy N Shaw, Vijay Srinivasan

Open access · diamondAbstract read
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Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Tara KaushalJoslin Diabetes Center, Section on Clinical, Behavioral and Outcomes Research, Pediatric, Adolescent and Young Adult Section, Boston, Mass.
Katherine LordChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Robert OlsenChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Sanjiv MehtaChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Stephanie ClarkChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Benjamin LaskinChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Danielle TraynorChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
April TaylorChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Kathy N ShawChildren's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, Pa.
Vijay SrinivasanChildren's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Philadelphia, Pa.
University of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn many centers, children with diabetic ketoacidosis (DKA) receive care either in an endocrinology ward or a pediatric intensive care unit (PICU). We conducted a quality improvement (QI) initiative to reduce potentially avoidable PICU admissions of children with DKA without increasing endocrinology ward-to-PICU transfers.

methodsA survey of providers demonstrated opportunities to increase awareness of institutional criteria for PICU admissions of children with DKA. We created an electronic health record (EHR) dot-phrase, prepopulated with these criteria, and placed a note in the EHR for all patients with DKA as a reference for all providers. An EHR-based data report was created to monitor the disposition of DKA patients and the use of the dot-phrase (process measure). The primary outcome measure was the potentially avoidable PICU admissions for patients with DKA. Endocrinology ward-to-PICU transfers were tracked as a balancing measure to ensure safe disposition.

resultsAfter the implementation of the dot-phrase, use was variable, but averaged 33.4% over 1 year. The percentage of DKA admissions classified as potentially avoidable PICU stays decreased from 4.1% to 0.5%, with a concurrent decrease in the total percentage of PICU admissions for DKA from 19.1% to 8.4%. The percentage of endocrinology ward-to-PICU transfers also declined from 0.8% to 0%.

conclusionsA novel EHR-based intervention increasing awareness and documentation of established pediatric DKA management guidelines can be used to safely reduce PICU admissions for DKA without increasing the rate of endocrinology ward-to-intensive care unit transfers.

Identifiers

PMID32426627
PMCPMC7190258
OpenAlexW3007034756

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.