title: Rates of ICU Transfers After a Scheduled Night-Shift Interprofessional Huddle.
abstract: OBJECTIVE
  To evaluate a scheduled interprofessional huddle among pediatric residents, nursing staff, and cardiologists on the number of high-risk transfers to the ICU.
  
  
  METHODS
  A daily, night-shift huddle intervention was initiated between the in-house pediatric residents and nursing staff covering the cardiology ward patients with the at-home attending cardiologist. Retrospective cohort chart review identified high-risk transfers from the inpatient floor to the ICU over a 24-month period (eg, inotropic support, intubation, and/or respiratory support within 1 hour of ICU transfer). Satisfaction with the intervention and the impact of the intervention on team-based communication and resident education was collected using a retrospective pre-post survey.
  
  
  RESULTS
  Ninety-three patients were identified as unscheduled transfers from the ward team to the ICU. Overall, 21 preintervention transfers were considered high risk, whereas only 8 patients were considered high risk after the intervention (P=.004). During the night shift, high risk transfers decreased from 8 of 17 (47%) to 3 of 21 patients (14%) (P=.03). Interprofessional communication improved with 12 of 14 nurses and 24 of 25 residents reporting effective communication after the intervention (P<.0001) compared with only 1 nurse and 15 residents reporting a positive experience before the intervention. Overall, all 3 provider groups stated an improved experience covering a high-risk cardiology patient population.
  
  
  CONCLUSIONS
  Implementation of an interprofessional huddle may contribute to decreasing high-risk transfers to the ICU. Initiating a daily huddle was well received and allowed for open lines of communication across all provider groups.
authors.affiliation: Department of Pediatrics, Sections of General Academic Pediatrics, renewman@cmh.edu.
authors.forename: Ross E
authors.initials: RE
authors.lastname: Newman
authors.affiliation: Cardiology, and.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Bingler
authors.affiliation: Critical Care Medicine, University of Missouri-Kansas City School of Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri; and.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Bauer
authors.affiliation: Center for Clinical Effectiveness, Quality Improvement, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Sections of General Academic Pediatrics.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Mann
mesh_terms: D001291:Attitude of Health Personnel; D002309:Cardiology / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D033183:Interdisciplinary Communication; D007396:Internship and Residency / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D009726:Nurses / Q000523:psychology / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000379:methods / Q000592:standards; D010372:Pediatrics / Q000379:methods / Q000592:standards; D010561:Personnel Staffing and Scheduling / Q000592:standards; D058996:Quality Improvement; D020379:Risk Adjustment