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Retrospective Review of Pediatric Transport: Where Do Our Patients Go After Transport?
Emily Krennerich1, Curtis G Sitler2, Manish Shah3
1Department of Pediatric Critical Care, Texas Children's Hospital, Houston, TX; Baylor College of Medicine, Houston, TX.
Insights
This study reviewed pediatric patient transports, finding that most critically ill children were appropriately placed in intensive care units. The findings support the efficient use of pediatric specialty transport teams for critical care needs.
Area of Science:
- Pediatric critical care medicine
- Transport medicine
- Healthcare quality improvement
Background:
- Pediatric specialty transport teams are crucial for critically ill children.
- Optimal patient placement ensures timely and appropriate care.
- Understanding transport disposition aids in resource allocation and training.
Purpose of the Study:
- To describe the disposition of children transported by a pediatric specialty team.
- To identify factors influencing appropriate patient placement.
- To assess the efficiency of pediatric transport services.
Main Methods:
- Retrospective chart review of pediatric transports from January 2012 to December 2014.
- Data sourced from transport quality assurance, electronic medical records, and transport records.
- Analysis of patient disposition and transport characteristics.
Main Results:
- 3,113 pediatric transports were analyzed.
- Majority of patients admitted to pediatric intensive care unit (47%) or step-down critical care (27%).
- 22% of patients were transported to lower-acuity units, with some requiring subsequent critical care.
Conclusions:
- Pediatric specialty transport teams efficiently manage critically ill children.
- Transported patients often require specialized pediatric services or emergency care.
- Findings highlight the need for ongoing evaluation of patient placement and team resources.
Objective:
This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training.
Methods:
A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records.
Results:
Three thousand two hundred fifty-six pediatric patient transports were reviewed. One hundred forty-three records were excluded. Of the remaining 3,113 patients, admission disposition was: 1,487 (47%) pediatric intensive care unit, 120 (4%) pediatric cardiovascular intensive care unit, 835 (27%) step-down critical care unit, 438 (14%) emergency department, 194 (6%) general floor, 29 (1%) neonatal intensive care unit, and 10 (< 1%) operating room. Of the 22% transported to a lower-acuity unit, several subsequently required critical care. Children transported for traumatic injuries had a shorter emergency department length of stay than medical patients.
Conclusion:
Our study validates the efficient use of pediatric specialty transport team resources. Many transported patients are critically ill, require specialized pediatric services, or require definitive pediatric emergency department care.
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