WIP 36 - Implementation of Standardized Multidisciplinary Communication for Intrahospital Transport of Critically Ill Pediatric Patients: A Quality Improvement Initiative

Publication Number: WIP 36.7433

Shannon C. Brougher, University of Texas Southwestern Medical School, Dallas, TX, United States; Amy Lee, University of texas southwestern medical school, Coppell, TX, United States; Olivia L. Hoffman, University of Texas Southwestern Medical School, Dallas, TX, United States

Background: Critically ill children frequently require intrahospital transport (IHT) for diagnostic or therapeutic interventions, often travelling between geographically separate and resource-variable areas of the hospital. IHT of critical patients introduces numerous variables that increase risk for adverse events and harm that are often identified as preventable. Literature reveals that a majority of critically ill children undergoing IHT experience significant physiologic derangement requiring subsequent major therapeutic intervention. Standardized communication in the context of IHT of critically ill children has been shown to improve patient outcomes.

Objective: We aim to develop and implement a standardized multidisciplinary communication strategy and checklist to mitigate the risk of IHT of critically ill children at our institution. We aim to evaluate utilization of the checklist and its effectiveness in reducing the number of transport-related adverse events, events requiring intervention, and total duration of transports.

Design/Methods: In collaboration with multidisciplinary key stakeholders, we are using standard QI methodology, including Plan-Do-Study-Act (PDSA) cycles, to implement a multidisciplinary peri-transport communication tool for patients in our 44-bed medical-surgical pediatric ICU (PICU). This tool consists of three phases: patient screening, pre-transport huddle, and post-transport debrief. Data for transport-related adverse events is captured during the debrief. Data will be analyzed utilizing standard QI methods including run and pareto charts, as well as Fischer’s exact test. The post-transport debrief was implemented in September 2024. Screening and huddle components for the initiative will be launched in December, with 2-4 week PDSA cycles to continue through March 2025. Three-month implementation data will be available for presentation in April 2025. The project was determined to be IRB-exempt by our institution.