Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: A pilot ethnography

Christina L. Cifra; Kimberly C. Dukes; Brennan S. Ayres; Kelsey A. Calomino; Loreen A. Herwaldt; Hardeep Singh; Heather Schacht Reisinger

doi:10.1016/j.jcrc.2020.09.011

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Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: A pilot ethnography

Journal article

Open access

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Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: A pilot ethnography

Christina L. Cifra, Kimberly C. Dukes, Brennan S. Ayres, Kelsey A. Calomino, Loreen A. Herwaldt, Hardeep Singh and Heather Schacht Reisinger

Journal of critical care, Vol.63, pp.246-249

06/01/2021

DOI: 10.1016/j.jcrc.2020.09.011

PMCID: PMC7969466

PMID: 32980235

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https://www.ncbi.nlm.nih.gov/pmc/articles/7969466View

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Abstract

Purpose: The effect of communication between referring and accepting clinicians during patient transitions to the pediatric intensive care unit (PICU) on diagnostic quality is largely unknown. This pilot study aims to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. Materials and methods: We conducted focused ethnography in an academic tertiary referral PICU by directly observing the referral and admission of 3 non-electively admitted children 0-17 years old. We also conducted 21 semi-structured interviews of their parents and admitting PICU staff (intensivists, fellows/residents, medical students, nurses, and respiratory therapists) and reviewed their medical records post-discharge. Results: Performing focused ethnography in a busy PICU is feasible. We identified three areas for additional exploration: (1) how information transfer affects the PICU diagnostic process; (2) how uncertainty in patient assessment affects the decision to transfer to the PICU; and (3) how the PICU team's expectations are influenced by referral communication. Conclusions: Focused ethnography in the PICU is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children. (c) 2020 Elsevier Inc. All rights reserved.

Critical Care Medicine

General & Internal Medicine

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: A pilot ethnography
Creators: Christina L. Cifra - Roy J. and Lucille A. Carver College of Medicine
Kimberly C. Dukes - University of Iowa
Brennan S. Ayres - Touro College
Kelsey A. Calomino - University of Iowa
Loreen A. Herwaldt - University of Iowa
Hardeep Singh - Michael E. DeBakey VA Medical Center
Heather Schacht Reisinger - University of Iowa
Resource Type: Journal article
Publication Details: Journal of critical care, Vol.63, pp.246-249
DOI: 10.1016/j.jcrc.2020.09.011
PMID: 32980235
PMCID: PMC7969466
NLM abbreviation: J Crit Care
ISSN: 0883-9441
eISSN: 1557-8615
Publisher: Elsevier
Number of pages: 4
Grant note: HD027748 / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA University of Iowa Carver College of Medicine Department of Pediatrics
Language: English
Date published: 06/01/2021
Academic Unit: Infectious Diseases; Stead Family Department of Pediatrics; Epidemiology; Center for Social Science Innovation; General Internal Medicine; Community and Behavioral Health; Internal Medicine
Record Identifier: 9984359693902771

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