• Christina L Cifra, Kimberly C Dukes, Brennan S Ayres, Kelsey A Calomino, Loreen A Herwaldt, Hardeep Singh, and Heather Schacht Reisinger.
• Division of Pediatric Critical Care, Department of Pediatrics, University of Iowa Carver College of Medicine, 200 Hawkins Dr 8600-M JCP, Iowa City, IA 52242, USA. Electronic address: christina-cifra@uiowa.edu.
• J Crit Care. 2021 Jun 1; 63: 246-249.

PurposeThe effect of communication between referring and accepting clinicians during patient transitions to the pediatric intensive care unit (PICU) on diagnostic quality is largely unknown. This pilot study aims to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children.Materials And MethodsWe conducted focused ethnography in an academic tertiary referral PICU by directly observing the referral and admission of 3 non-electively admitted children 0-17 years old. We also conducted 21 semi-structured interviews of their parents and admitting PICU staff (intensivists, fellows/residents, medical students, nurses, and respiratory therapists) and reviewed their medical records post-discharge.ResultsPerforming focused ethnography in a busy PICU is feasible. We identified three areas for additional exploration: (1) how information transfer affects the PICU diagnostic process; (2) how uncertainty in patient assessment affects the decision to transfer to the PICU; and (3) how the PICU team's expectations are influenced by referral communication.ConclusionsFocused ethnography in the PICU is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.Copyright © 2020 Elsevier Inc. All rights reserved.

22 keywords...

hide…