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Updates to referring clinicians regarding critically ill children admitted to the pediatric intensive care unit: a state-wide survey
Journal article   Peer reviewed

Updates to referring clinicians regarding critically ill children admitted to the pediatric intensive care unit: a state-wide survey

Christina L. Cifra, Cody R. Tigges, Sarah L. Miller, Loreen A. Herwaldt and Hardeep Singh
Diagnosis (Berlin, Germany), Vol.7(2), pp.123-128
06/01/2020
DOI: 10.1515/dx-2019-0048
PMCID: PMC7732519
PMID: 31652117
url
https://www.ncbi.nlm.nih.gov/pmc/articles/7732519View
Open Access

Abstract

Background: Front-line clinicians are expected to make accurate and timely diagnostic decisions before transferring patients to the pediatric intensive care unit (PICU) but may not always learn their patients' outcomes. We evaluated the characteristics of post-transfer updates received by referring clinicians regarding PICU patients and determined preferences regarding content, delivery, and timing of such updates. Methods: We administered an electronic cross-sectional survey to Iowa clinicians who billed for >= 5 pediatric patients or referred >= 1 patient to the University of Iowa (UI) PICU in the year before survey administration. Results: One hundred and one clinicians (51 non-UI, 50 UI-affiliated) responded. Clinicians estimated that, on average, 8% of pediatric patients they saw over 1 year required PICU admission; clinicians received updates on 40% of patients. Seventy percent of UI clinicians obtained updates via self-initiated electronic record review, while 37% of non-UI clinicians relied on PICU communication (p = 0.013). Clinicians indicated that updates regarding diagnoses/outcomes will be most relevant to their practice. Among clinicians who received updates, 13% received unexpected information; 40% changed their practice as a result. Conclusions: Clinicians received updates on less than half of the patients they referred to a PICU, although such updates could potentially influence clinical practice. Study findings will inform the development of a formal feedback system from the PICU to referring clinicians.
General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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