Caring for Children in the Pediatric Intensive Care Unit
Posted November 2, 2009
The care of critically ill children has become increasingly complex for healthcare organizations to manage. With a focus on improving patient outcomes such as length of stay, mortality, and critical incidents, a team of attending physicians and internal consultants at Children's Healthcare of Atlanta (Children's) conducted a workflow analysis to improve the existing rounding process in the Pediatric Intensive Care Unit (PICU). The recommendations from this study were implemented in December 2008.
To measure the impact of these recommended changes and to further explore opportunities for improving patient care, during the summer of 2009, Dr. Atul Vats and Kristin Goin from Children's joined forces with Professor Pinar Keskinocak and Ph.D. students Monica Villarreal and Tuba Yilmaz from the Stewart School of Industrial and Systems Engineering (ISyE) at Georgia Tech. The Children's/Georgia Tech team used human factors techniques and statistical tools to collect and analyze observational data for eleven rounding events before and twelve rounding events after process re-design. They also conducted staff surveys to assess improvements in communication and care coordination, and analyzed customer satisfaction data to evaluate impact on patient experience. The study showed that the implementation of the new lean-focused, patient-centric rounding structure led to increased timeliness and efficiency of rounds, improved staff and customer satisfaction, improved throughput, and reduced attending physician man-hours.
The results of the study will be presented at the 2010 Society of Critical Care Medicine (SCCM) Congress on January 9-13, 2010 in Miami, Florida. The abstract summarizing the findings of the study received one of the ten 2010 Annual Scientific Awards from SCCM, out of the 1,240 abstracts submitted to the congress. The abstract will be published in the supplement of the Critical Care Medicine Journal in December 2009.
The focus areas of the Children's/Georgia Tech team's ongoing collaboration include physician workflow issues, scheduling and patient handoff efficiencies, and inter-unit patient flow.