Feasibility and Perceived Value of a Team Diagnostic Timeout: A Multi-Institutional Pilot Study

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.