009 - Improving Pediatric Intensive Care Unit Communication and Engagement with Primary Care Physicians During the Hospital Stay

Publication Number: 9.5307

Sarah Neale, Inova Children's Hospital, Arlington, VA, United States; Rhiya Dave, Inova Children's Hospital, Falls Church, VA, United States; Nicholas Errico, Inova Children's Hospital, Arlington, VA, United States; Hannah L. Bashaw, Inova Children's Hospital, Vienna, VA, United States; Courtney Port, Inova Children’s Hospital, Falls church, VA, United States; William Stotz, Inova Children's Hospital, Fairfax, VA, United States

Background: Effective communication between primary care pediatricians (PCP) and pediatric intensive care unit (PICU) physicians is essential for ensuring high-quality care and optimal outcomes in critically ill pediatric patients. Seamless information exchange supports continuity of care, reduces medical errors, and enhances patient and family satisfaction. Research has highlighted the value of real-time discussions, such as phone calls, in improving communication, collaborative decision-making, and comprehensive understanding of patient conditions.

Prior to implementing this process, our institution relied on an EMR integrated system to fax signed admission notes to the PCP to notify them of an admission.

Objective: Increase the percentage of PICU encounters where the PCP is notified of the admission from 65% to 95% in 3 months.

Design/Methods: A standardized workflow was created to encourage interpersonal communication in which each patient’s PCP office was contacted by phone, informing them of the admission and providing a direct phone line to the PICU physician for additional communication. Project measures included the proportion of admissions with accurate PCP listed and PCP notification, the number of PCP calls to the PICU physician, and the time spent notifying PCPs.

Results: A total of 207 encounters were reviewed, 77 baseline and 130 post-intervention. Accuracy of PCP information documented within the EMR increased from a median of 87% to 100%. The percentage of encounters with PCP notification increased from a median of 65% to 94%. The number of PCP calls to the PICU physician increased from 0 to 19 (14.6% of post-intervention encounters). Interestingly, there was a post-intervention increase in PCP visits to their admitted patients from 0 to 1. The average time spent notifying PCP offices of patient admissions was 25 minutes.

Conclusion(s): Using quality improvement methodology, we succeeded in improving the percentage of PICU encounters with PCP notification nearly to our goal of 95%. An increase in subsequent communication through physician calls and visits may suggest enhanced quality of communication or a greater sense of collaboration. Further investigation is required to explore these potential benefits.

Communication from the PICU to the PCP about the Patient's Admission