| Title: |
Sustained Performance of Cardiac Arrest Prevention in Pediatric Cardiac Intensive Care Units |
| Authors: |
Mueller, Dana; Bailly, David K.; Banerjee, Mousumi; Bertrandt, R.A.; Borasino, Santiago; Briceno-Medina, Mario; Chan, Titus; Diddle, J. Wesley; Domnina, Yuliya; Clarke-Myers, Katherine; Connelly, Chloe; Florez, Amy; Gaies, Michael; Garza, Janie; Ghassemzadeh, Rod; Lane, John; McCammond, Amy N.; Olive, Mary K.; Ortmann, Laura; Prodhan, Parthak; Raymond, Tia Tortoriello; Sasaki, Jun; Scahill, Carly; Schroeder, Luke W.; Schumacher, Kurt R.; Werho, David K.; Zhang, Wenying; Alten, Jeffrey; Jones, Megan A.; Miller, Benjamin; Wellman, Katherine; Benscoter, Alexis; Cooper, David S.; Wooton, Sharyl; Moellinger, Ashley; Scalici McAtee, Maria; Zaccagni, Hayden; Kane, Janie; Roper, Stephanie; Bradley, Brittany; Dick, Ashley; Bhakta, Rupal T; Das, Ashima; Shah, Tejas; Burton, Grant; Clay, Mark; Centers, Gabriela; Wong, Rudy; Absi, Mohammed; Grandberry, Michelle H. |
| Source: |
JAMA Network Open ; volume 7, issue 9, page e2432393 ; ISSN 2574-3805 |
| Publisher Information: |
American Medical Association (AMA) |
| Publication Year: |
2024 |
| Description: |
Importance The Pediatric Cardiac Critical Care Consortium (PC4) cardiac arrest prevention (CAP) quality improvement (QI) project facilitated a decreased in-hospital cardiac arrest (IHCA) incidence rate across multiple hospitals. The sustainability of this outcome has not been determined. Objective To examine the IHCA incidence rate at participating hospitals after the QI project ended and discern which factors best aligned with sustained improvement. Design, Setting, and Participants This observational cohort study compared IHCA data from the CAP era (July 1, 2018, to December 31, 2019) with data from the 2-year follow-up era (March 1, 2020, to February 28, 2022). Data were obtained from pediatric cardiac intensive care units (CICUs) from 17 PC4 CAP–participating hospitals. Intervention The CAP practice bundle was designed to facilitate local practice integration, with the intention to implement, adapt, and continue CAP processes beyond the CAP era. A web-based survey was administered 2 years after the end of the project to estimate CAP-specific QI work. Main Outcomes and Measures Risk-adjusted IHCA incidence rates across all admissions were compared between study eras. The survey generated a novel hospital-specific QI sustainability score, which is generally reflective of the sum of local CAP work performed. Results There were no clinically important differences in demographic and admission characteristics between the 13 082 CAP era admissions and 16 284 follow-up admissions (total mean [SD] age, 5.1 [8.4] years; 56.1% male). Risk-adjusted IHCA incidences were not different between the CAP vs follow-up eras (2.8% vs 2.8%; odds ratio, 1.03; 95% CI, 0.89-1.19), suggesting sustained prevention improvement. There was also no difference between eras in risk-adjusted IHCA incidence within medical, surgical, or high-risk subgroups. A lower hospital QI sustainability score was correlated with higher odds for IHCA in the follow-up vs CAP era (correlation coefficient, −0.58; P = .02). Five hospitals had increases of 1% ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1001/jamanetworkopen.2024.32393 |
| Availability: |
https://doi.org/10.1001/jamanetworkopen.2024.32393; https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2823182/mueller_2024_oi_240972_1724790297.09778.pdf |
| Accession Number: |
edsbas.1F421ADA |
| Database: |
BASE |