About: Improving Disposition Decision-Making for Pediatric Diabetic Ketoacidosis: A Quality Improvement Study

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Improving Disposition Decision-Making for Pediatric Diabetic Ketoacidosis: A Quality Improvement Study
Creator	Shaw, Kathy Clark, Stephanie Kaushal, Tara Laskin, Benjamin Lord, Katherine Mehta, Sanjiv Olsen, Robert Srinivasan, Vijay Taylor, April Traynor, Danielle
Source	PMC
abstract	INTRODUCTION: In many centers, children with diabetic ketoacidosis (DKA) receive care either in an endocrinology ward or a pediatric intensive care unit (PICU). We conducted a quality improvement (QI) initiative to reduce potentially avoidable PICU admissions of children with DKA without increasing endocrinology ward-to-PICU transfers. METHODS: A survey of providers demonstrated opportunities to increase awareness of institutional criteria for PICU admissions of children with DKA. We created an electronic health record (EHR) dot-phrase, prepopulated with these criteria, and placed a note in the EHR for all patients with DKA as a reference for all providers. An EHR-based data report was created to monitor the disposition of DKA patients and the use of the dot-phrase (process measure). The primary outcome measure was the potentially avoidable PICU admissions for patients with DKA. Endocrinology ward-to-PICU transfers were tracked as a balancing measure to ensure safe disposition. RESULTS: After the implementation of the dot-phrase, use was variable, but averaged 33.4% over 1 year. The percentage of DKA admissions classified as potentially avoidable PICU stays decreased from 4.1% to 0.5%, with a concurrent decrease in the total percentage of PICU admissions for DKA from 19.1% to 8.4%. The percentage of endocrinology ward-to-PICU transfers also declined from 0.8% to 0%. CONCLUSIONS: A novel EHR-based intervention increasing awareness and documentation of established pediatric DKA management guidelines can be used to safely reduce PICU admissions for DKA without increasing the rate of endocrinology ward-to-intensive care unit transfers.
has issue date	2020-02-15(xsd:dateTime)
bibo:doi	10.1097/pq9.0000000000000260
bibo:pmid	32426627
has license	cc-by-nc-nd
sha1sum (hex)	bf9994929a199da5b05183e4db1114494e2061c2
schema:url	https://doi.org/10.1097/pq9.0000000000000260
resource representing a document's title	Improving Disposition Decision-Making for Pediatric Diabetic Ketoacidosis: A Quality Improvement Study
has PubMed Central identifier	PMC7190258
has PubMed identifier	32426627
schema:publication	Pediatr Qual Saf
resource representing a document's body	covid:bf9994929a199da5b05183e4db1114494e2061c2#body_text
is schema:about of	named entity 'declined' named entity 'endocrinology' named entity 'admissions' named entity 'quality improvement' named entity 'Decision-Making' named entity 'Individual' named entity 'ENDOCRINOLOGY' named entity 'CONCLUSIONS' named entity 'RATE' named entity 'CENTERS' named entity 'DKA' named entity 'report' named entity 'total' named entity 'DKA' named entity 'DKA' named entity 'conducted' named entity 'disposition' named entity 'ketoacidosis' named entity 'awareness' named entity 'DKA' named entity 'DKA' named entity 'initiative' named entity 'DKA' named entity 'endocrinology' named entity 'DKA' named entity 'endocrinology' named entity 'Endocrinology' named entity 'endocrinology' named entity 'diabetic ketoacidosis' named entity 'PICU' named entity 'primary outcome measure' named entity 'DKA' named entity 'PICU' named entity 'Diabetic Ketoacidosis' named entity 'tracked' named entity 'PDSA' named entity 'ICU' named entity 'statistical process control' named entity 'PICU' named entity 'p-chart' named entity 'glucose' named entity 'attending physician' named entity 'institutional review board' named entity 'DKA' named entity 'endocrinology' named entity 'PICU' named entity 'attending physician' named entity 'EHR' named entity 'DKA' named entity 'DKA' named entity 'endocrinology' named entity 'quality control' named entity 'VPS' named entity 'PDSA' named entity 'EHR' named entity 'PICU' named entity 'root cause analysis' named entity 'DKA' named entity 'PICU' named entity 'PICU' named entity 'ICU' named entity 'PICU' named entity 'obesity' named entity 'PICU' named entity 'EHR' named entity 'Pediatric' named entity 'PICU' named entity 'DKA' named entity 'Epic Systems' named entity 'endocrinology' named entity 'PICU' named entity 'clinical data'

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