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Variation in care practices across pediatric acute care cardiology units: Results of the Pediatric Acute Care Cardiology Collaborative (PAC3) hospital survey

dc.contributor.authorHoerst, Amanda
dc.contributor.authorBakar, Adnan
dc.contributor.authorCassidy, Steven C.
dc.contributor.authorClabby, Martha
dc.contributor.authorGrippo, Erica Del
dc.contributor.authorGraupe, Margaret
dc.contributor.authorHarahsheh, Ashraf S.
dc.contributor.authorHlavacek, Anthony M.
dc.contributor.authorHart, Stephen A.
dc.contributor.authorKipps, Alaina K.
dc.contributor.authorMadsen, Nicolas L.
dc.contributor.authorO’neil, Dora D.
dc.contributor.authorPatel, Sonali S.
dc.contributor.authorStrohacker, Courtney M.
dc.contributor.authorTanel, Ronn E.
dc.date.accessioned2019-06-20T17:05:08Z
dc.date.available2020-07-01T17:47:46Zen
dc.date.issued2019-05
dc.identifier.citationHoerst, Amanda; Bakar, Adnan; Cassidy, Steven C.; Clabby, Martha; Grippo, Erica Del; Graupe, Margaret; Harahsheh, Ashraf S.; Hlavacek, Anthony M.; Hart, Stephen A.; Kipps, Alaina K.; Madsen, Nicolas L.; O’neil, Dora D. ; Patel, Sonali S.; Strohacker, Courtney M.; Tanel, Ronn E. (2019). "Variation in care practices across pediatric acute care cardiology units: Results of the Pediatric Acute Care Cardiology Collaborative (PAC3) hospital survey." Congenital Heart Disease (3): 419-426.
dc.identifier.issn1747-079X
dc.identifier.issn1747-0803
dc.identifier.urihttps://hdl.handle.net/2027.42/149524
dc.description.abstractBackgroundThe Pediatric Acute Care Cardiology Collaborative (PAC3) was established in 2014 to improve the quality, value, and experience of hospitalâ based cardiac acute care outside of the intensive care unit. An initial PAC3 project was a comprehensive survey to understand unit structure, practices, and resource utilization across the collaborative. This report aims to describe the previously unknown degree of practice variation across member institutions.MethodsA 126â stem question survey was developed with a total of 412 possible response fields across nine domains including demographics, staffing, available resources and therapies, and standard care practices. Five supplemental questions addressed surgical case volume and number of cardiac acute care unit (CACU) admissions. Responses were recorded and stored in Research Electronic Data Capture (REDCap).ResultsSurveys were completed by 31 out of 34 centers (91%) with minimal incomplete fields. A majority (61%) of centers have a single dedicated CACU, which is contiguous or adjacent to the intensive care unit in 48%. A nurse staffing ratio of 3:1 is most common (71%) and most (84%) centers employed a resource nurse. Centralized wireless rhythm monitoring is used in 84% of centers with 54% staffed continuously. There was significant variation in the use of noninvasive respiratory support, vasoactive infusions, and ventricular assist devices across the collaborative. Approximately half of the surveyed centers had lesionâ specific postoperative pathways and approximately twoâ thirds had protocols for singleâ ventricle patients.ConclusionsThe PAC3 hospital survey is the most comprehensive description of systems and care practices unique to CACUs to date. There exists considerable heterogeneity among unit composition and variation in care practices. These variations may allow for identification of best practices and improved quality of care for patients.
dc.publisherWiley Periodicals, Inc.
dc.subject.otherinpatient cardiology
dc.subject.otherquality improvement
dc.subject.otherpediatric cardiology
dc.subject.othercardiovascular care unit
dc.titleVariation in care practices across pediatric acute care cardiology units: Results of the Pediatric Acute Care Cardiology Collaborative (PAC3) hospital survey
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelInternal Medicine and Specialties
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/149524/1/chd12739.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/149524/2/chd12739_am.pdf
dc.identifier.doi10.1111/chd.12739
dc.identifier.sourceCongenital Heart Disease
dc.identifier.citedreferenceKipps AK, Cassidy SC, Strohacker CM, et al. Collective quality improvement in the pediatric cardiology acute care unit: establishment of the Pediatric Acute Care Cardiology Collaborative (PAC3). Cardiol Young. 2018; 28: 1019 â 1023.
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dc.identifier.citedreferenceJones DA, DeVita MA, Bellomo R. Rapidâ response teams. N Engl J Med. 2011; 365: 139 â 146.
dc.identifier.citedreferenceHarris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)â a metadataâ driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009; 42: 377 â 381.
dc.identifier.citedreferenceMott AR, Neish SR, Challman M, Feltes TF. Defining pediatric inpatient cardiology care delivery models: a survey of pediatric cardiology programs in the USA and Canada. Congenital Heart Dis. 2017; 12: 294 â 300.
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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