Design and Implementation of a Pediatric ICU Acuity Scoring Tool as Clinical Decision Support

Shelov, Eric; Muthu, Naveen; Wolfe, Heather; Traynor, Danielle; Craig, Nancy; Bonafide, Christopher P.; Davis, Daniela; Dewan, Maya

doi:10.1055/s-0038-1667122

Cited by 18 publications

(21 citation statements)

References 33 publications

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“…The increased patient load cannot serve as an excuse for the knowledge gap regarding high-risk status and mitigation plan, but may provide an opportunity to support residents and other medical providers through the use of clinical decisionsupport tools that indicate high-risk status and represent mitigation plans. 12 This study has multiple limitations. First, while we based our survey tool on a communication assessment tool with prior validity evidence, 10,12 our tool has not been used prior to this study.…”

Section: Discussionmentioning

confidence: 95%

The Effects of Care Team Roles on Situation Awareness in the Pediatric Intensive Care Unit: A Prospective Cross‐Sectional Study

Soberano

Brady

Yunger

et al. 2020

Journal of Hospital Medicine

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Improved situation awareness (SA) decreases rates of clinical deterioration in the pediatric inpatient setting. We used a prospective, cross-sectional, observational study to measure interprofessional care team SA for a pediatric intensive care unit (PICU) patients. The resident, bedside nurse, and respiratory therapist for each patient were surveyed regarding high clinical deterioration risk status as defined by clinical criteria identified by the PICU fellow or attending and mitigation plan. From March 2018 to July 2019, we surveyed 400 care team trios caring for 73 high-risk patients. Nurses identified the patient’s risk status correctly for 375 of 400 patients (94%), respiratory therapists, 380 (95%; P = .4), and residents, 349 (87%; P = .002). For the 73 high-risk patients, nurses were correct 82% of the time, respiratory therapists, 85%, P = .7, and residents, 67%, P = .04. Interventions targeting resident SA are needed within the PICU, especially for high-risk patients.

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Section: Discussionmentioning

confidence: 95%

The Effects of Care Team Roles on Situation Awareness in the Pediatric Intensive Care Unit: A Prospective Cross‐Sectional Study

Soberano

Brady

Yunger

et al. 2020

Journal of Hospital Medicine

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“…For example, such requirements would have to be met for the integration in a decision support system (DSS) as other authors have done with other information using the Guideline Interchange Format (GLIF) 20 21 22 or scoring tools. 23 The emergency checklists in this study are first and foremost used for the developed GUI and the project purpose only. However, the identified requirements for a digital CA data model are comparable with requirements that existing guideline models such as the Guideline Elements Model (GEM) 24 or GLIF meet.…”

Section: Discussionmentioning

confidence: 99%

Data Model Requirements for a Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management

et al. 2020

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Objective The aim of this study is to define data model requirements supporting the development of a digital cognitive aid (CA) for intraoperative crisis management in anesthesia, including medical emergency text modules (text elements) and branches or loops within emergency instructions (control structures) as well as their properties, data types, and value ranges. Methods The analysis process comprised three steps: reviewing the structure of paper-based CAs to identify common text elements and control structures, identifying requirements derived from content, design, and purpose of a digital CA, and validating requirements by loading exemplary emergency checklist data into the resulting prototype data model. Results The analysis of paper-based CAs identified 19 general text elements and two control structures. Aggregating these elements and analyzing the content, design and purpose of a digital CA revealed 20 relevant data model requirements. These included checklist tags to enable different search options, structured checklist action steps (items) in groups and subgroups, and additional information on each item. Checklist and Item were identified as two main classes of the prototype data model. A data object built according to this model was successfully integrated into a digital CA prototype. Conclusion To enable consistent design and interactivity with the content, presentation of critical medical information in a digital CA for crisis management requires a uniform structure. So far it has not been investigated which requirements need to be met by a data model for this purpose. The results of this study define the requirements and structure that enable the presentation of critical medical information. Further research is needed to develop a comprehensive data model for a digital CA for crisis management in anesthesia, including supplementation of requirements resulting from simulation studies and feasibility analyses regarding existing data models. This model may also be a useful template for developing data models for CAs in other medical domains.

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“…Dengan demikian EHRs dapat membantu perawat mengambil keputusan untuk melakukan tindakan dengan cepat. Shelov et al, (2018) dalam penelitiannya menjelaskan alat CDS otomatis dalam EHRs, berupa peringatan dalam EHRs dalam format PICU Warning tool, untuk meningkatkan perhatian terhadap kondisi pasien di ruang PICU dapat berfungsi sangat efektif secara otomatis mengidentifikasi kondisi pasien yang berisiko memburuk.…”

Section: Pembahasanunclassified

Peranan Electronic Health Record System terhadap Keselamatan Pasien di Perawatan Anak

Yayah

Rahman

2020

JIKO

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EHRs merupakan bentuk perkembangan teknologi informasi berupa sistem dokumentasi kesehatan dalam format digital yang dapat memberikan tampilan data otomatis yang mendukung dalam kelengkapan dan keakuratan data yang diharapkan dapat meningkatkan keselamatan pasien termasuk di perawatan anak. Karena anak merupakan populasi yang rentan dalam isu keselamatan pasien. Tujuan penelitian ini adalah untuk mengetahui peranan EHRs terkait keselamatan pasien di perawatan anak. Penelitian ini menggunakan studi literatur dengan melakukan kajian artikel dan jurnal penelitian yang dicari melalui penelusuran database online yang terbit tahun 2014-2019 dengan kata kunci “electronic health record” OR “electronic medical record” AND “pediatric” AND “patient safety” sebanyak 10 artikel dijadikan bahan analisis utama ditambahkan artikel lainnya sebagai sebagai pendukung pembahasan. Hasil penelitian ini menunjukan bahwa EHRs yang sudah dimodifikasi dengan menampilkan umpan balik tanda waspada berupa sistem peringatan dengan tampilan visual dapat meningkatkan komunikasi yang efektif antar tim kesehatan, memberikan peringatan dalam keamanan dan kewaspadaan obat, serta deteksi dini sepsis pada anak sehingga mendukung pengambilan keputusan untuk melakukan tindakan yang tepat untuk meningkatkan keselamatan pasien. EHRs yang sudah dimodifikasi dengan sistem pendukung berupa sistem peringatan memiliki peranan positif dan efektif dalam meningkatkan keselamatan pasien di perawatan anak.

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Design and Implementation of a Pediatric ICU Acuity Scoring Tool as Clinical Decision Support

Abstract: We describe the successful adaptation and implementation of a real-time CDS tool to identify PICU patients at risk of deterioration. Prospective multicenter evaluation of the tool's effectiveness on clinical outcomes is necessary before broader implementation can be recommended.

Cited by 18 publications

References 33 publications

The Effects of Care Team Roles on Situation Awareness in the Pediatric Intensive Care Unit: A Prospective Cross‐Sectional Study

The Effects of Care Team Roles on Situation Awareness in the Pediatric Intensive Care Unit: A Prospective Cross‐Sectional Study

Data Model Requirements for a Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management

Peranan Electronic Health Record System terhadap Keselamatan Pasien di Perawatan Anak

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