Development of Complexity Assessment and Monitoring to Ensure Optimal Outcomes Acuity Curves.

Area of Science:

• Pediatric Cardiac Surgery
• Intensive Care Medicine
• Healthcare Management

Background:

• The Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO) tool was designed for nurse staffing.
• A novel application, CAMEO Acuity Curves, is proposed to identify high-acuity phases post-congenital heart surgery.
• Understanding patient acuity is crucial for resource allocation in pediatric cardiac intensive care units (CICUs).

Purpose of the Study:

• To characterize CAMEO acuity scores for common congenital heart surgeries.
• To analyze acuity trends throughout cardiac intensive care unit (CICU) admissions.
• To establish a framework for acuity-based patient management in pediatric cardiac surgery.

Main Methods:

• Retrospective review of 205 congenital heart procedures (Stage I palliation, Arterial Switch Operation (ASO), Tetralogy of Fallot repair) from January 2017 to January 2020.
• Utilized CAMEO Acuity Curves to assess postoperative patient acuity.
• Stratified acuity by Residual Lesion Score (RLS) severity within each procedure type.

Main Results:

• Overall mean CAMEO scores indicated highest acuity for Stage I palliation (76%), followed by ASO (69%), and Tetralogy of Fallot repair (62%).
• Acuity progressively increased with higher Residual Lesion Scores (RLS 3 > RLS 2 > RLS 1) across all procedures.
• CAMEO Acuity Curves successfully mapped postoperative acuity timelines within the CICU.

Conclusions:

• CAMEO Acuity Curves provide a visual timeline of postoperative acuity in the CICU.
• This method allows for the description and comparison of acuity across varying surgical complexities.
• Findings can inform clinical decision-making and optimize nurse staffing to meet patient care demands.