Abstract：
OBJECTIVE: We hypothesized that collaborative intervention to improve weighted pediatric readiness score (WPRS) will be associated with decreased pediatric intensive care (PICU) mortality, PICU and hospital length of stay.
METHODS: This study analyzes the transfer of acutely ill and injured patients from general emergency departments (GEDs) to our institution. The intervention involved customized assessment reports focusing on team performance and systems improvement for pediatric readiness, sharing best practices and clinical resources, designation of a nurse PECC at each GED and ongoing interactions at 2 and 4 months. Data was collected from charts before and after the intervention, focusing on patients transferred to our pediatric emergency department (ED) or directly admitted to our PICU from the GEDs. Clinical outcomes such as PICU length of stay (LOS), hospital LOS, and PICU mortality were assessed. Descriptive statistics were used for demographics, and various statistical tests were employed to analyze the data. Bivariate analyses and multivariable models were utilized to examine patient outcomes and the association between the intervention and outcomes.
RESULTS: There were 278 patients in the pre-intervention period and 314 patients in the post-intervention period. Multivariable analyses revealed a significant association between the change in WPRS and decreased PICU LOS (β=-0.05 [95% CI: -0.09, -0.01), p=0.023), and hospital LOS (β=-0.12 [95% CI: -0.21, -0.04], p=0.004), but showed no association between the intervention and other patient outcomes.
CONCLUSIONS: In this cohort, improving pediatric readiness scores in GEDs was associated with significant improvements in PICU and hospital length of stay. Future initiatives should focus on disseminating pediatric readiness efforts to improve outcomes of critically ill children nationally.
UNASSIGNED: Improving pediatric readiness scores in general emergency departments is associated with improved downstream clinical outcomes demonstrated by reduced PICU and hospital length of stay.
METHODS: This study analyzes the transfer of acutely ill and injured patients from general emergency departments (GEDs) to our institution. The intervention involved customized assessment reports focusing on team performance and systems improvement for pediatric readiness, sharing best practices and clinical resources, designation of a nurse PECC at each GED and ongoing interactions at 2 and 4 months. Data was collected from charts before and after the intervention, focusing on patients transferred to our pediatric emergency department (ED) or directly admitted to our PICU from the GEDs. Clinical outcomes such as PICU length of stay (LOS), hospital LOS, and PICU mortality were assessed. Descriptive statistics were used for demographics, and various statistical tests were employed to analyze the data. Bivariate analyses and multivariable models were utilized to examine patient outcomes and the association between the intervention and outcomes.
RESULTS: There were 278 patients in the pre-intervention period and 314 patients in the post-intervention period. Multivariable analyses revealed a significant association between the change in WPRS and decreased PICU LOS (β=-0.05 [95% CI: -0.09, -0.01), p=0.023), and hospital LOS (β=-0.12 [95% CI: -0.21, -0.04], p=0.004), but showed no association between the intervention and other patient outcomes.
CONCLUSIONS: In this cohort, improving pediatric readiness scores in GEDs was associated with significant improvements in PICU and hospital length of stay. Future initiatives should focus on disseminating pediatric readiness efforts to improve outcomes of critically ill children nationally.
UNASSIGNED: Improving pediatric readiness scores in general emergency departments is associated with improved downstream clinical outcomes demonstrated by reduced PICU and hospital length of stay.
摘要：
目的：我们假设协同干预以改善加权儿科准备评分（WPRS）将与降低儿科重症监护（PICU）死亡率相关。PICU和住院时间。
方法：本研究分析了重症和受伤患者从普通急诊科（GED）转移到我们机构的情况。干预措施涉及定制的评估报告，重点是团队绩效和系统改进，以改善儿科准备情况。分享最佳实践和临床资源，在每次GED指定一名护士PECC，并在2个月和4个月进行互动。从干预前后的图表中收集数据，重点关注从GED转移到儿科急诊科（ED）或直接从GED进入PICU的患者。临床结果，如PICU住院时间（LOS），医院LOS,并对PICU死亡率进行了评估。描述性统计数据用于人口统计，并采用各种统计检验对数据进行分析。双变量分析和多变量模型用于检查患者的结果以及干预和结果之间的关联。
结果：干预前的患者为278例，干预后的患者为314例。多变量分析显示，WPRS的变化与PICULOS降低之间存在显着关联（β=-0.05[95％CI：-0.09，-0.01），p=0.023),和医院LOS（β=-0.12[95%CI：-0.21，-0.04]，p=0.004),但显示干预和其他患者结局之间没有关联。
结论：在这个队列中，提高GEDs的儿科治疗准备评分与PICU和住院时间的显著改善相关.未来的举措应侧重于传播儿科准备工作，以改善全国危重患儿的预后。
提高普通急诊科的儿科准备评分与改善下游临床结局相关，这表现为PICU和住院时间的减少。
方法：本研究分析了重症和受伤患者从普通急诊科（GED）转移到我们机构的情况。干预措施涉及定制的评估报告，重点是团队绩效和系统改进，以改善儿科准备情况。分享最佳实践和临床资源，在每次GED指定一名护士PECC，并在2个月和4个月进行互动。从干预前后的图表中收集数据，重点关注从GED转移到儿科急诊科（ED）或直接从GED进入PICU的患者。临床结果，如PICU住院时间（LOS），医院LOS,并对PICU死亡率进行了评估。描述性统计数据用于人口统计，并采用各种统计检验对数据进行分析。双变量分析和多变量模型用于检查患者的结果以及干预和结果之间的关联。
结果：干预前的患者为278例，干预后的患者为314例。多变量分析显示，WPRS的变化与PICULOS降低之间存在显着关联（β=-0.05[95％CI：-0.09，-0.01），p=0.023),和医院LOS（β=-0.12[95%CI：-0.21，-0.04]，p=0.004),但显示干预和其他患者结局之间没有关联。
结论：在这个队列中，提高GEDs的儿科治疗准备评分与PICU和住院时间的显著改善相关.未来的举措应侧重于传播儿科准备工作，以改善全国危重患儿的预后。
提高普通急诊科的儿科准备评分与改善下游临床结局相关，这表现为PICU和住院时间的减少。
