Unplanned transfer of pediatric patients from the general ward to the intensive care unit

Area of Science:

• Pediatric critical care medicine
• Hospital quality improvement
• Patient safety research

Background:

• Hospitalized pediatric patients can experience clinical deterioration requiring unplanned transfer to the pediatric intensive care unit (PICU).
• These events may indicate unnoticed deterioration and impact patient morbidity and mortality.
• Understanding unplanned transfers is crucial for assessing and improving care quality.

Purpose of the Study:

• To determine the frequency of unplanned transfers from the general pediatric ward (GPW) to the PICU.
• To analyze the causes, clinical characteristics, and outcomes of these transfers.
• To differentiate between urgent and emergent transfer criteria and their implications.

Main Methods:

• A prospective, descriptive study design was employed.
• Data were collected on all unplanned transfers from the GPW to the PICU between January 1, 2014, and December 31, 2019.
• Analysis included transfer frequency, causes, patient comorbidities, and outcomes.

Main Results:

• A total of 212 unplanned transfers were recorded (21 per 1000 admissions).
• Comorbidities were present in 76% of patients, with cancer being the most frequent (36%).
• Leading causes for transfer included respiratory distress (43%), sepsis (20%), and neurological/neurosurgical complications (20%).
• The overall mortality rate was 8.96%.

Conclusions:

• Unplanned transfers serve as a critical indicator of care quality and patient safety.
• Integrating unplanned transfer analysis into performance dashboards is recommended.
• Viewing unplanned transfers as potentially preventable events represents a significant shift in patient care paradigms.