Alert 2014-progress-auerbach
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1) This study used simulations of critically ill pediatric patients to compare the quality of care provided by pediatric emergency departments (PED) and general emergency departments (GED). 2) 168 simulation cases involving 4 different illness scenarios were conducted across 21 departments (8 PED and 13 GED) to assess differences in structure, processes and outcomes of care. Data was collected through videos, surveys and direct observation. 3) Results found differences in safety scores and adherence to guidelines between PED and GED. Ongoing analysis includes case studies and measuring the impact on real patient outcomes. The study aims to improve pediatric emergency care in all emergency settings.
Alert 2014-progress-auerbach
- 1. Marc Auerbach, MD, MSci1, David Kessler, MD, Msci6, Barbara Walsh, MD2, Susan Walsh, MD1, Marcie Gawel, RN1, Jessica Katznelson, MD3, Jaewon Jang, PHD1, Megan Lavoie, MD4, Yen Tay, MD4, Robert Dudas, MD3, Brian Schultz, MD5, Melinda Hamilton, MD5, Sandeep Gangadharan, MD7 and Linda Brown, MD, MSCE8. 1Yale University, New Haven, CT, United States; 2University of Massachusetts Medical School, Wooster, MA, United States; 3Johns Hopkins University, Baltimore, MD, United States; 4University of Pennsylvania, Philadelphia, PA, United States; 5University of Pittsburgh, Pittsburgh, PA, United States; 6Columbia University, New York, NY, United States; 7Hofstra University, New Hyde Park, NY, United States and 8Brown University, Providence, RI, United States. INSPIRE @ IMSH 2014: San Francisco, California,USA International Network for Simulation-based Pediatric Innovation, Research and Education
- 2. Background • Critically ill pediatric patients are rare events – Not feasible for all communities to have pediatric acute care specialists in ED – Deserve optimal care whenever/wherever it is needed • Optimal outcomes require safe, timely and effective recognition/diagnosis/treatment International Network for Simulation-based Pediatric Innovation, Research and Education
- 3. PICO Question • P: Simulated critically ill pediatric patients • I: PED • C: GED • O: Quality of care: structure, process, outcome International Network for Simulation-based Pediatric Innovation, Research and Education
- 4. Approach / Design • Intervention (simulations) 1. Foreign Body, 2. Sepsis, 3. Seizure, 4. PEA/Vfib – In-situ, own resources/equipment/space, simulated medications – 21 departments (8 PED, 13 GED) – 2 inter-professional teams/dept (6-8 providers) – 4 cases/team (168 cases) • Data capture – EMSC Readiness Instrument, Provider Pre-survey – Research RN: volume, medication, dose (standard form) – Video: time/process of care (2 cameras, monitor, simulator) • Data analysis – Safety score (FMEA analysis), benchmarking – STAT tool, Adherence to guidelines International Network for Simulation-based Pediatric Innovation, Research and Education
- 5. Timeline • Grant Proposal- Rbaby 2/1/13 to 1/31/14, planning AHRQ, EMSC • IRB Submission/Recruitment/Data Collection- 2/1/13- 1/31/14 • Data Analysis- ongoing • Abstract Presentation- PAS • Manuscript Preparation- multiples submissions in progress – Systematic review – Case specific– Cardiac, Sepsis – Safety score analysis International Network for Simulation-based Pediatric Innovation, Research and Education
- 6. 3 Questions to improve study 1. How do we balance customization with quality? 2. What is the best model for sustainability? Who should pay for this? How do we prove value? 3. How do we correlate with real patient outcomes? International Network for Simulation-based Pediatric Innovation, Research and Education
- 7. Contact Information Marc Auerbach, Yale University Marc.auerbach@yale.edu 203-737-7437 http://medicine.yale.edu/lab/impacts/index.aspx International Network for Simulation-based Pediatric Innovation, Research and Education
Editor's Notes
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