Children's Hospital Researchers Say New Measure May Improve Rapid Response Systems Treatment of Critically Ill Patients

PHILADELPHIA, March 21, 2012 /PRNewswire-USNewswire/ -- Researchers at The Children's Hospital of Philadelphia have developed a faster way to measure the effectiveness of the rapid response systems that identify and emergently treat children who suddenly and unexpectedly become critically ill while hospitalized in non-intensive care settings.

Cardiac and respiratory arrests—the outcomes traditionally used to measure rapid response system effectiveness—are rare in children. Studies on how to best treat children in non-intensive care settings who are at risk of these bad outcomes require years of data to show definitive improvements.  The new approach developed by the team at Children's Hospital measures outcomes for a wider group of patients within a shorter period of time. The study, "Development of a Pragmatic Measure for Evaluating and Optimizing Rapid Response Systems," was published online March 5 in the journal Pediatrics.

"It's a way to rapidly understand -- over months rather than years --  if we are making hospitals safer," said lead author Christopher P. Bonafide, M.D., M.S.C.E., a pediatric researcher  at Children's Hospital. The research was done with support from the Center for Pediatric Clinical Effectiveness at The Children's Hospital of Philadelphia.

The study team reviewed records of 724 medical emergency team and 56 "code-blue" team activations in Children's Hospital between February 2010 and February 2011. The researchers created a metric known as "critical deterioration," defined as the number of patients transferred to the ICU and requiring life-sustaining interventions, such as intubation, within 12 hours.

Currently, studies of outcomes are based on the Child Health Corporation of America (CHCA) Codes Outside the ICU Whole System Measure. Using the CHCA measure, cardiac or respiratory arrest outside the ICU occurred only 14 times during the study year.  In contrast, using the "critical deterioration" metric, the researchers identified 121 patients and were able to study the success rate of the practices used to treat those critically ill children.  Patients in this category also showed a high risk of in-hospital death; nearly 17% of children with critical deterioration died prior to hospital discharge, the researchers said.

"The metric broadens the lens to look at the next tier of kids who become critically ill, but may not reach the point of cardiac or respiratory arrest," says Bonafide. "Further studies should be done to determine whether this broader metric should be used to measure the success of children's hospitals nationally."

Other study authors are Kathryn E. Roberts, R.N., M.S.N.; Margaret A. Priestley, M.D.; Kathleen M. Tibbetts, M.S.; Emily Huang; Vinay M. Nadkarni, M.D., M.S. and Ron Keren, M.D., M.P.H., all of Children's Hospital.

To view the full report, click here: http://pediatrics.aappublications.org

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 516-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.

Contact: Juliann Walsh, Public Relations
The Children's Hospital of Philadelphia
Office Phone: 267-426-6054
Email: [email protected]

SOURCE The Children's Hospital of Philadelphia