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Development and Implementation of a Peer Curbside Consult Service for Pediatric Hospitalists
Laura B O'Neill1, Priti Bhansali1, Margaret Rush1
1Division of Hospital Medicine, Children's National Hospital, Washington, DC.
Insights
A new Peer Curbside Consult Service (PCCS) offers timely clinical decision support for pediatric hospital medicine (PHM) divisions. This peer consultation model can be replicated by other divisions seeking to improve care for complex cases.
Area of Science:
- Pediatric hospital medicine
- Clinical decision support
- Healthcare quality improvement
Background:
- Challenging clinical cases in pediatric hospital medicine require timely expert support.
- Existing consultation models may not always provide immediate assistance.
- A structured peer consultation service can bridge this gap.
Purpose of the Study:
- To describe the development and implementation of a Peer Curbside Consult Service (PCCS) within a pediatric hospital medicine (PHM) division.
- To provide a replicable model for other institutions to establish similar peer consultation programs.
Main Methods:
- A pilot intervention was developed and implemented at a freestanding children's hospital.
- The Template for Intervention Description and Replication (TIDieR) checklist guided the process description.
- Postconsultation surveys collected feedback from requesting and consulting hospitalists.
Main Results:
- The PCCS provided 60 consultations in its first 2 years, supporting over 75 PHM members across multiple sites.
- Consultations were primarily conducted in person or via telephone.
- High survey response rates (70% requesting, 89% consulting) indicate program engagement.
Conclusions:
- A successful peer consult service was established, offering just-in-time clinical decision support.
- Transparent reporting using the TIDieR checklist facilitates replication and adaptation by other divisions.
Objective:
To describe the development and implementation of a Peer Curbside Consult Service (PCCS) for a pediatric hospital medicine (PHM) division.
Methods:
We developed a pilot intervention with hospitalists at a freestanding children's hospital to provide peer consultation services for challenging clinical cases. Postconsultation surveys collected from both the requesting and consulting hospitalists provided feedback about the program. The 12-point Template for Intervention Description and Replication (TIDieR) checklist is used to describe the process for program creation and implementation.
Results:
The PCCS has provided 60 consultations in the first 2 years since implementation in April 2020 and supports a large PHM division with >75 members who practice at a tertiary care, freestanding children's hospital and 7 affiliate sites. Hospitalists request peer consultation for challenging clinical cases. The consultations were typically conducted in person or via telephone. Currently, 11 PHM faculty members within the division volunteer as consultants, with 2 assigned per week. Electronic postconsultation experience surveys were received from 70% of requesting and 89% of consultant hospitalists. We also provide preliminary data from this pilot intervention in the Supplemental Information.
Conclusions:
We successfully established a peer consult service that provided just-in-time clinical decision support across the various practice sites. Through transparent reporting using the TIDieR checklist, other divisions may be able to replicate and adapt their own peer consult program.
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