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Crit Care Res Pract. 2018 May 9;2018:9187962. doi: 10.1155/2018/9187962. eCollection 2018.

Design and Deployment of a Pediatric Cardiac Arrest Surveillance System.

Author information

1
Division of Health Sciences Informatics, Department of Anesthesiology and Critical Care Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
2
Department of Occupational Health, The Johns Hopkins Hospital, Baltimore, MD, USA.
3
Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA.
4
Department of Anesthesiology and Critical Care Medicine and Department of Pediatrics, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
5
Department of Anesthesiology and Critical Care Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
6
Department of Pediatrics, The Johns Hopkins Hospital, Baltimore, MD, USA.
7
Neonatology Respiratory Therapy, The Johns Hopkins Hospital, Baltimore, MD, USA.
8
Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.

Abstract

Objective:

We aimed to increase detection of pediatric cardiopulmonary resuscitation (CPR) events and collection of physiologic and performance data for use in quality improvement (QI) efforts.

Materials and Methods:

We developed a workflow-driven surveillance system that leveraged organizational information technology systems to trigger CPR detection and analysis processes. We characterized detection by notification source, type, location, and year, and compared it to previous methods of detection.

Results:

From 1/1/2013 through 12/31/2015, there were 2,986 unique notifications associated with 2,145 events, 317 requiring CPR. PICU and PEDS-ED accounted for 65% of CPR events, whereas floor care areas were responsible for only 3% of events. 100% of PEDS-OR and >70% of PICU CPR events would not have been included in QI efforts. Performance data from both defibrillator and bedside monitor increased annually. (2013: 1%; 2014: 18%; 2015: 27%).

Discussion:

After deployment of this system, detection has increased ∼9-fold and performance data collection increased annually. Had the system not been deployed, 100% of PEDS-OR and 50-70% of PICU, NICU, and PEDS-ED events would have been missed.

Conclusion:

By leveraging hospital information technology and medical device data, identification of pediatric cardiac arrest with an associated increased capture in the proportion of objective performance data is possible.

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