. 2021 Jul 2;67(3):fmaa058.

doi: 10.1093/tropej/fmaa058.

Effectiveness of a Daily Rounding Checklist on Processes of Care and Outcomes in Diverse Pediatric Intensive Care Units Across the World

Rahul Kashyap^{1

2}, Srinivas Murthy³, Grace M Arteaga^{2

4}, Yue Dong^{1

2}, Lindsey Cooper⁵, Tanja Kovacevic⁶, Chetak Basavaraja⁷, Hong Ren⁸, Lina Qiao⁹, Guoying Zhang¹⁰, Kannan Sridharan¹¹, Ping Jin¹², Tao Wang¹⁰, Ilisapeci Tuibeqa¹³, An Kang⁸, Mandyam Dhanti Ravi⁷, Ebru Ongun¹⁴, Ognjen Gajic^{2

15}, Sandeep Tripathi^{2

4

16}; SCCM Discovery CERTAINp Collaborative Investigators

Collaborators, Affiliations

Collaborators

SCCM Discovery CERTAINp Collaborative Investigators:
Srinivas Murthy, Ping Jin, Hong Ren, An Kang, Lina Qiao, Tao Wang, Guoying Zhang, Lindsey Cooper, Tanja Kovacevic, Julije Mestrovic, Branka Polic, Josko Markic, Kannan Sridharan, IIisapeci Tuibeqa, Laila Sauduadua, Chetak Basavaraja, Mandyam Dhanti Ravi, Ellan Devaraj, Ebru Ongun, Grace M Arteaga, Hongchuan Coville, Yue Dong, Lei Fan, Ognjen Gajic, Bo Hong, Manasi Hulyalkar, An Kang, Rahul Kashyap, Harsheen Kaur, Dipti Padhya, Moldovan Sabov, Reina Suzuki, Sandeep Tripathi

Affiliations

¹ Department of Anesthesiology and Peri-operative Medicine, Mayo Clinic, Rochester, MN, USA.
² METRIC-Multidisciplinary and Translational Research in Intensive Care Medicine, Mayo Clinic, Rochester, MN, USA.
³ Division of Critical Care, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Pediatric Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
⁵ Department of Pediatrics/Intensive Care, Centre Medicale Evangelique-Nyankunde, Nyankunde, Democratic Republic of the Congo.
⁶ School of Medicine and University Hospital of Split, Split, Croatia.
⁷ JSS Academy of Higher Education and Research (JSSAHER), JSS Hospital, Mysuru, KA, India.
⁸ Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁹ Sichuan University West China Second Hospital, Chengdu, China.
¹⁰ Chengdu Women and Children's central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
¹¹ Department of Pharmacology, College of Medicine, Nursing and Health Sciences, Fiji national University, Suva, Fiji.
¹² Bao'an Maternity & Child Health Hospital, Shenzhen, China.
¹³ Department of Pediatrics, Colonial war memorial Hospital, Suva, Fiji.
¹⁴ Akdeniz University Hospital, Antalya, Turkey.
¹⁵ Divison of Pulmonary and Care Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁶ Pediatric Critical Care Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.

PMID: 32853362
PMCID: PMC8488874
DOI: 10.1093/tropej/fmaa058

Effectiveness of a Daily Rounding Checklist on Processes of Care and Outcomes in Diverse Pediatric Intensive Care Units Across the World

Rahul Kashyap et al. J Trop Pediatr. 2021.

. 2021 Jul 2;67(3):fmaa058.

doi: 10.1093/tropej/fmaa058.

Authors

Collaborators

SCCM Discovery CERTAINp Collaborative Investigators:
Srinivas Murthy, Ping Jin, Hong Ren, An Kang, Lina Qiao, Tao Wang, Guoying Zhang, Lindsey Cooper, Tanja Kovacevic, Julije Mestrovic, Branka Polic, Josko Markic, Kannan Sridharan, IIisapeci Tuibeqa, Laila Sauduadua, Chetak Basavaraja, Mandyam Dhanti Ravi, Ellan Devaraj, Ebru Ongun, Grace M Arteaga, Hongchuan Coville, Yue Dong, Lei Fan, Ognjen Gajic, Bo Hong, Manasi Hulyalkar, An Kang, Rahul Kashyap, Harsheen Kaur, Dipti Padhya, Moldovan Sabov, Reina Suzuki, Sandeep Tripathi

Affiliations

¹ Department of Anesthesiology and Peri-operative Medicine, Mayo Clinic, Rochester, MN, USA.
² METRIC-Multidisciplinary and Translational Research in Intensive Care Medicine, Mayo Clinic, Rochester, MN, USA.
³ Division of Critical Care, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Pediatric Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
⁵ Department of Pediatrics/Intensive Care, Centre Medicale Evangelique-Nyankunde, Nyankunde, Democratic Republic of the Congo.
⁶ School of Medicine and University Hospital of Split, Split, Croatia.
⁷ JSS Academy of Higher Education and Research (JSSAHER), JSS Hospital, Mysuru, KA, India.
⁸ Pediatric Intensive Care Unit, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁹ Sichuan University West China Second Hospital, Chengdu, China.
¹⁰ Chengdu Women and Children's central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
¹¹ Department of Pharmacology, College of Medicine, Nursing and Health Sciences, Fiji national University, Suva, Fiji.
¹² Bao'an Maternity & Child Health Hospital, Shenzhen, China.
¹³ Department of Pediatrics, Colonial war memorial Hospital, Suva, Fiji.
¹⁴ Akdeniz University Hospital, Antalya, Turkey.
¹⁵ Divison of Pulmonary and Care Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁶ Pediatric Critical Care Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.

PMID: 32853362
PMCID: PMC8488874
DOI: 10.1093/tropej/fmaa058

Erratum in

Correction to: Effectiveness of a Daily Rounding Checklist on Processes of Care and Outcomes in Diverse Pediatric Intensive Care Units Across the World.
[No authors listed] [No authors listed] J Trop Pediatr. 2022 Jun 6;68(4):fmac051. doi: 10.1093/tropej/fmac051. J Trop Pediatr. 2022. PMID: 35762536 Free PMC article. No abstract available.

Abstract

Background: Implementation of checklists has been shown to be effective in improving patient safety. This study aims to evaluate the effectiveness of implementation of a checklist for daily care processes into clinical practice of pediatric intensive care units (PICUs) with limited resources.

Methods: Prospective before-after study in eight PICUs from China, Congo, Croatia, Fiji, and India after implementation of a daily checklist into the ICU rounds.

Results: Seven hundred and thirty-five patients from eight centers were enrolled between 2015 and 2017. Baseline stage had 292 patients and post-implementation 443. The ICU length of stay post-implementation decreased significantly [9.4 (4-15.5) vs. 7.3 (3.4-13.4) days, p = 0.01], with a nominal improvement in the hospital length of stay [15.4 (8.4-25) vs. 12.6 (7.5-24.4) days, p = 0.055]. The hospital mortality and ICU mortality between baseline group and post-implementation group did not show a significant difference, 14.4% vs. 11.3%; p = 0.22 for each. There was a variable impact of checklist implementation on adherence to various processes of care recommendations. A decreased exposure in days was noticed for; mechanical ventilation from 42.6% to 33.8%, p < 0.01; central line from 31.3% to 25.3%, p < 0.01; and urinary catheter from 30.6% to 24.4%, p < 0.01. Although there was an increased utilization of antimicrobials (89.9-93.2%, p < 0.01).

Conclusions: Checklists for the treatment of acute illness and injury in the PICU setting marginally impacted the outcome and processes of care. The intervention led to increasing adherence with guidelines in multiple ICU processes and led to decreased length of stay.

Keywords: LMIC; checklists; critical care; patient safety; pediatric; quality improvement.

PubMed Disclaimer

Conflict of interest statement

R.K. and O.G. have a financial conflict of interest related to adult ICU checklist software applications licensed to Ambient Clinical Analytics Inc. The related research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest policies.

Figures

**Fig. 1.**
Flow diagram of the study—patient enrollment in pre- and post-groups.

**Fig. 2.**
Number of patients enrolled per center in pre- and post-groups.

See this image and copyright information in PMC

References

1. Murthy S, Leligdowicz A, Adhikari NK.. Intensive care unit capacity in low-income countries: a systematic review. PLoS One 2015;10:e0116949. - PMC - PubMed
1. Riviello ED, Letchford S, Achieng L, et al.Critical care in resource-poor settings: lessons learned and future directions. Crit Care Med 2011;39:860–7. - PubMed
1. Murthy S, Adhikari NK.. Global health care of the critically ill in low-resource settings. Ann Am Thorac Soc 2013;10:509–13. - PubMed
1. Cubro H, Somun-Kapetanovic R, Thiery G, et al.Cost effectiveness of intensive care in a low resource setting: a prospective cohort of medical critically ill patients. World J Crit Care Med 2016;5:150–64. - PMC - PubMed
1. Lipkus IM. Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations. Med Decis Making 2007;27:696–713. - PubMed

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Effectiveness of a Daily Rounding Checklist on Processes of Care and Outcomes in Diverse Pediatric Intensive Care Units Across the World

Collaborators

Affiliations

Effectiveness of a Daily Rounding Checklist on Processes of Care and Outcomes in Diverse Pediatric Intensive Care Units Across the World

Authors

Collaborators

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources