Evidence map›Paper›PMID 38623378›Full record

ArticleResuscitation plus2024

Implementation of a critical care outreach team in a children's hospital.

Sanjiv Mehta, Meghan M Galligan, Kim Tran Lopez, Chip Chambers, Daniel Kabat, Kelly Papili, Hannah Stinson, Robert M Sutton

Open access · goldAbstract read
In one paragraph

Article in Resuscitation plus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
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

8 authors at 3 institutions in 1 country.

Sanjiv MehtaDepartment of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, United States.
Meghan M GalliganDepartment of Pediatrics, Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, United States.
Kim Tran LopezDepartment of Pediatrics, Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, United States.
Chip ChambersPerelman School of Medicine at the University of Pennsylvania, United States.
Daniel KabatDepartment of Digital and Technology Services, Children's Hospital of Philadelphia, United States.
Kelly PapiliDepartment of Anesthesiology and Critical Care, Children's Hospital, United States.
Hannah StinsonDepartment of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, United States.
Robert M SuttonDepartment of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, United States.
Children's Hospital of Philadelphia · USBoston Children's Hospital · USUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Proactive surveillance by a critical care outreach team (CCOT) can promote early recognition of deterioration in hospitalized patients but is uncommon in pediatric rapid response systems (RRSs). After our children's hospital introduced a CCOT in 2019, we aimed to characterize early implementation outcomes. We hypothesized that CCOT rounding would identify additional children at risk for deterioration. Methods: The CCOT, staffed by a dedicated critical care nurse (RN), respiratory therapist, and attending, conducts daily in-person rounds with charge RNs on medical-surgical units, to screen RRS-identified high-risk patients for deterioration. In this prospective study, observers tracked rounds discussion content, participation, and identification of new high-risk patients. We compared 'identified-patient-discussions' (IPD) about RRS-identified patients, and 'new-patient-discussions' (NPD) about new patients with Fisher's exact test. For new patients, we performed thematic analysis of clinical data to identify deterioration related themes. Results: During 348 unit-rounds over 20 days, we observed 383 discussions - 35 (9%) were NPD. Frequent topics were screening for clinical concerns (374/383, 98%), active clinical concerns (147/383, 39%), and watcher activation (66/383, 17%). Most discussions only included standard participants (353/383, 92%). Compared to IPD, NPD more often addressed active concerns (74.3% vs 34.8%, Conclusion: A successfully implemented CCOT enhanced identification of clinical deterioration not captured by existing RRS resources. Future work will investigate its impact on operational safety and patient-centered outcomes.

Indexed as

Clinical DeteriorationCritical Care OutreachHigh reliability organizationsPatient safetyPediatricProactiveRapid Response System

Identifiers

PMID38623378
PMCPMC11016912
OpenAlexW4394733035

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.