Related Experiment Video
Updated: Jun 4, 2026
Design to Implementation Study for Development and Patient Validation of Paper-Based Toehold Switch Diagnostics
Published on: June 17, 2022
Feasibility and Perceived Value of a Team Diagnostic Timeout: A Multi-Institutional Pilot Study
Jonathan Sawicki1, Elise Buckwalter2, Emily Tooley2
1Primary Children's Hospital, Salt Lake City, Utah.
Insights
A diagnostic timeout (DT) during unplanned pediatric intensive care unit (PICU) transfers is feasible in under 5 minutes. Its perceived value increased when bedside nurses or families participated.
Area of Science:
- Pediatric critical care medicine
- Healthcare quality improvement
- Patient safety
Background:
- Unplanned transfers to the pediatric intensive care unit (PICU) can be complex.
- A diagnostic timeout (DT) is a strategy to improve care during these transitions.
- Assessing the feasibility and value of DTs is crucial for implementation.
Purpose of the Study:
- To evaluate the feasibility and perceived value of implementing a diagnostic timeout (DT).
- To assess DT utilization across a national pediatric learning network during unplanned PICU transfers.
Main Methods:
- A DT was implemented during unplanned transfers to the PICU across 4 children's hospitals.
- Surveys assessed participant roles, time required, and perceived value immediately after the DT.
- Responses were analyzed based on team member participation.
Main Results:
- DTs were used in 43% of unplanned transfers, with significant site variation.
- Over 90% of DTs were completed in 5 minutes or less.
- Improved team understanding was the most valued aspect; enhanced differential diagnosis was least valued. Higher agreement was noted when bedside nurses or patients/families were present.
Conclusions:
- Diagnostic timeouts are feasible within 5 minutes during unplanned PICU transfers.
- DT adoption varied significantly across participating sites.
- The perceived value of DTs is highest when bedside nurses and/or patients/families are involved.
Objective:
To describe the feasibility and perceived value of a diagnostic timeout (DT) across a national pediatric learning network.
Methods:
The DT was implemented during unplanned transfers from general care to the pediatric intensive care unit (PICU) from April 2024 through June 2024 at 4 children's hospitals. One health care team member filled out a survey immediately after the DT to assess participant roles, the time required, and the perceived value. Responses were stratified by which team members participated and compared using chi-square tests.
Results:
Overall, a DT was performed in 43% (78 of 182) of unplanned transfers with notable heterogeneity in its use across sites (site A, 75% [18 of 24]; site B, 56% [22 of 39]; site C, 53% [36 of 68]; site D, 4% [2 of 51]). Over 90% of DTs took 5 minutes or less. The value statement "Improved interdisciplinary team understanding of the priorities and plan of care" received the highest number of "Agree/Strongly Agree" responses (47%; 37 of 78), and the statement "Changed or added to the differential diagnosis" received the fewest (28%; 22 of 78). There was a statistically higher percentage of "Agree/Strongly Agree" responses to most survey statements when the bedside nurse or patient and/or family were present.
Conclusions:
The adoption of a DT during unplanned PICU transfers varied considerably across sites but was feasible in under 5 minutes. The perceived value was greatest when the patient and/or family or bedside nurse were present. Future studies are needed to better understand how best to implement a DT and how it impacts diagnostic error.
