ArticlePediatric quality & safety
Utilization of Kotter's Stages and Statistical Process Control to Implement and Sustain Delirium Screening in PICU.
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 3 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Pooled it
- Sedation in Critically Ill Children.Journal of clinical medicine · 2025Review
- Challenges of the Implementation of a Delirium Rate Scale in a Pediatric Intensive Care Unit: A Qualitative Approach.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Delirium is a preventable cause of ICU morbidity and mortality. Prior unstructured efforts to implement delirium screening in our hospital were unsuccessful. This project aimed to improve the delirium screening compliance from baseline 0% to more than 80% within 12 months (07/2019-06/2020).
methodsWe utilized Kotter's stages of transformation as guiding blocks for implementing change and undertook simultaneous efforts to decrease delirium rates. In addition, we used statistical process control to monitor screening compliance and delirium rates.
resultsEducation on delirium assessment and prevention created a sense of urgency among nursing and medical staff (Stage #1). Stakeholder analysis and a key driver diagram were presented to leadership to create a guiding coalition (Stage #2). Process mapping and failure mode and effect analysis created a vision and strategy for the project (Stage #3). Multiple methods were utilized to communicate the change vision (Stage #4) and empower broad-based action (Stage #5). We celebrated small incremental achievements or short-term wins (Stage #6) by reporting delirium compliance and rate on a control chart. We completed 5837 delirium screens on 763 patients (6689 opportunities). The median delirium screening compliance rate was 87.2% (13.4% positive screens). Small achievements produced by the project were communicated to staff, propelling future efforts to recognize and prevent delirium. This momentum was a driver for more change (Stage #7) to ensure a long-term cultural change in the unit (Stage #8).
conclusionKotter's principle of change management, along with an emphasis on data-driven process control, may result in sustained improvement.
Identifiers
What OpenQuestion holds
Registered trials
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.