Neonatology
Hospital-based Medicine
Education Pathway
Quality Improvement/Patient Safety
Emergency Medicine
Critical Care
Aaron Donoghue, MD, MSCE
Associate Professor of Critical Care Medicine and Pediatrics
Perelman School of Medicine at the University of Pennsylvania
CHOP
Philadelphia, Pennsylvania, United States
Resuscitation of critically ill children presents unique challenges to both pediatric and general acute care providers. Resuscitation team members are drawn from a large pool of health care providers (HCP) with highly variable skill and experience levels. These teams are often required to perform resuscitations with limited information on underlying patient morbidity or physiologic risk factors, at any time of day or night, and with minimal advanced warning. Such fundamental procedures as cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) are universally required but infrequently performed. The high acuity, low frequency nature of these events make it difficult for the individual health care provider, and by extension, the resuscitation team, to maintain clinical competency and to provide optimal resuscitation to those children who are critically ill.
The use of videorecording during clinical care has robust history in trauma resuscitation and care of the newly born infant in the delivery room. Over the past decade, a growing body of literature has demonstrated the usefulness of video review as a needs assessment, a quality improvement tool, and a data source for research in pediatric resuscitation. Video review provides clear, unbiased data on these uncommon and highly dynamic patient encounters and can yield elusive information about clinical care, teamwork, communication, and provider interactions.
In this presentation, we explore the use of clinical videorecording and several applications to assessing and improving resuscitative care. All presenting authors work in academic pediatric centers and have independently, and jointly, led efforts to improve both the care of critically ill patients in the PED and PICU and the training and education of the HCPs who provide this care. Topics covered in this presentation will include: 1) the use of video review as a novel methodology for teaching both CPR performance and ETI skills, 2) application of Crew Resource Management methods for improving resuscitation team leadership and communication, 3) development and implementation of high frequency, on-shift, in-situ simulation programs, and 4) the use of safety checklists to decrease systems variability and cognitive workload during resuscitations.
Presenter: Sage Myers, MD, MSCE – Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
Presenter: Aaron Donoghue, MD, MSCE – Perelman School of Medicine at the University of Pennsylvania
Presenter: Benjamin T. Kerrey, MD, MS – Cincinnati Children's Hospital Medical Center, Univeristy of Cincinnati College of Medicine
Presenter: Karen O'Connell, MD, MEd – Children's National Hospital
Presenter: Tara L. Neubrand, MD – University of Colorado/Children's Hospital Colorado
Presenter: -- --
Presenter: -- --