Related Experiment Videos
Implementation strategies in pediatric neurocritical care
Christopher Markham1, Enola K Proctor, Jose A Pineda
1aDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis Children's Hospital bGeorge Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA.
Current Opinion in Pediatrics
|April 1, 2017
Summary
Implementing specialized pediatric neurocritical care pathways improves survival and outcomes for critically ill children with neurological conditions. Effective strategies enhance patient care in pediatric intensive care units.
Area of Science:
- Pediatric critical care medicine
- Neurology
- Neurosurgery
- Implementation science
Background:
- Pediatric neurocritical care is an emerging subspecialty integrating neurology, neurosurgery, and critical care.
- The optimal implementation of specialized care for acute neurological conditions in children is not well understood.
- Evidence suggests specialized care positively impacts pediatric patients with acute neurological illness.
Purpose of the Study:
- To present evidence supporting the improved survival and outcomes through effective pediatric neurocritical care pathway implementation.
- To offer an overview of implementation science strategies for deploying neurocritical care pathways in pediatric ICUs.
Main Methods:
- Implementation strategies are categorized into planning, education, restructuring, financing, quality management, and policy context.
- Review of institutional experiences over the past decade utilizing combined implementation strategies.
- Focus on evidence-based care pathways for status epilepticus and traumatic brain injury in critically ill children.
Main Results:
- Several institutions have reduced patient morbidity and mortality by applying a combination of implementation strategies.
- Emerging evidence indicates improved outcomes for critically ill children with status epilepticus and traumatic brain injury.
- Implementation strategies can be effectively grouped and applied to improve patient care.
Conclusions:
- Pediatric and neonatal neurocritical care programs can be structured using evidence-based care and sequenced implementation strategies.
- Effective implementation strategies can improve outcomes across diverse pediatric patient populations and healthcare settings.
- Structured neurocritical care programs enhance patient care and outcomes in pediatric intensive care units.