High Acuity Therapy Variation Across Pediatric Acute Care Cardiology Units: Results from the Pediatric Acute Care Cardiology Collaborative Hospital Surveys.
High Acuity Therapy Variation Across Pediatric Acute Care Cardiology Units: Results from the Pediatric Acute Care Cardiology Collaborative Hospital Surveys.
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DOI：
10.1007/s00246-021-02584-3
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发表时间：
2021-06
影响因子：
1.6
通讯作者：
Pediatric Acute Care Cardiology Collaborative (PAC3)
中科院分区：
文献类型：
--
作者：
Harahsheh AS;Kipps AK;Hart SA;Cassidy SC;Clabby ML;Hlavacek AM;Hoerst AK;Graupe MA;Madsen NL;Bakar AM;Del Grippo EL;Patel SS;Bost JE;Tanel RE;Pediatric Acute Care Cardiology Collaborative (PAC3)
我们利用2017年和2019年多中心儿科急性护理心脏病学协作（PAC 3）调查来描述治疗可用性的实践变化和2年内的变化。从44个调查问题中得出高敏度治疗（AT）评分（每个阳性回答1分），并将评分与中心手术量进行比较。在完成2017年调查的31家中心中，有26家也完成了2019年调查。2017年的得分为11至34分，2019年为11至35分。2019年的AT评分与2017年的评分无统计学差异（29/44，IQR 27-32.5 vs. 29.5/44，IQR 27-31，p = 0.9）。2019年，与2017年相比，更多中心报告在急性心脏病监护室（ACCU）启动持续气道正压通气（CPAP）和双水平气道正压通气（BiPAP）（19/26 vs. 4/26，p < 0.001），并允许连续CPAP/BiPAP（22/26 vs. 14/26，p = 0.034）。最高手术量组在两个调查年的评分均显著高于最低手术量组，分别为33 ± 1.5与25 ± 8.5，p = 0.046和32 ± 1.7与23 ± 5.5，p = 0.009。参与PAC 3的ACCU内的治疗变化为整个协作过程中的共享学习提供了机会。PAC 3经验与2017年至2019年可用呼吸治疗的增加相关。AT评分是否会影响儿科急性心脏病护理的质量和结局，将是使用2019年初启动的综合登记研究进行进一步调查的主题。
We utilized the multicenter Pediatric Acute Care Cardiology Collaborative (PAC3) 2017 and 2019 surveys to describe practice variation in therapy availability and changes over a 2-year period. A high acuity therapies (ATs) score was derived (1 point per positive response) from 44 survey questions and scores were compared to center surgical volume. Of 31 centers that completed the 2017 survey, 26 also completed the 2019 survey. Scores ranged from 11 to 34 in 2017 and 11 to 35 in 2019. AT scores in 2019 were not statistically different from 2017 scores (29/44, IQR 27–32.5 vs. 29.5/44, IQR 27–31, p = 0.9). In 2019, more centers reported initiation of continuous positive airway pressure (CPAP) and Bi-level positive airway pressure (BiPAP) in Acute Care Cardiology Unit (ACCU) (19/26 vs. 4/26, p < 0.001) and permitting continuous CPAP/BiPAP (22/26 vs. 14/26, p = 0.034) compared to 2017. Scores in both survey years were significantly higher in the highest surgical volume group compared to the lowest, 33 ± 1.5 versus 25 ± 8.5, p = 0.046 and 32 ± 1.7 versus 23 ± 5.5, p = 0.009, respectively. Variation in therapy within the ACCUs participating in PAC3 presents an opportunity for shared learning across the collaborative. Experience with PAC3 was associated with increasing available respiratory therapies from 2017 to 2019. Whether AT scores impact the quality and outcomes of pediatric acute cardiac care will be the subject of further investigation using a comprehensive registry launched in early 2019.
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影响因子：
0.3
作者：
Hoerst, Amanda;Bakar, Adnan;Tanel, Ronn E.
通讯作者：
Tanel, Ronn E.
DOI：
10.1161/circoutcomes.115.001956
发表时间：
2015-07-01
影响因子：
6.9
作者：
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通讯作者：
Lannon, Carole
影响因子：
1
作者：
Gaies, Michael;Anderson, Jeffrey;Pearson, Gail
通讯作者：
Pearson, Gail
影响因子：
1.6
作者：
Harahsheh, Ashraf S.;Hom, Lisa A.;Martin, Gerard R.
通讯作者：
Martin, Gerard R.
先天性心脏手术后重症监护病房和急性护理单位住院时间。
DOI：
10.1016/j.athoracsur.2020.01.033
发表时间：
2020-10
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Hart SA;Tanel RE;Kipps AK;Hoerst AK;Graupe MA;Cassidy SC;Hlavacek AM;Clabby ML;Bush LB;Zhang W;Banerjee MM;Pasquali SK;Gaies M;Madsen N
通讯作者：
Madsen N