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Recommended Citation
Brown J, Stewart J, McCrory M. Improving Post-Operative Disposition Accuracy to Decrease Unscheduled Pediatric Intensive Care Unit Admissions. Quality Improvement podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Quality Improvement podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Background: Unscheduled post operative admissions to the pediatric intensive care unit strain hospital resources due to the inability to plan for staffing, services, supplies, and bed availability. Understanding trends in these admissions is critical to improving efficiency, timeliness and quality of care. Unscheduled cardiovascular admissions are associated with longer length of stay and increased mortality. Additionally, among unscheduled admissions after anesthesia, 33% are predictable and 19% preventable, indicating intervention opportunities.
Local Problem: At our institution, 52% of post-operative admissions to the pediatric intensive care unit were unscheduled, significantly higher than the Virtual Pediatric Systems comparison group rate of 34% (p < 0.0001). Internal review revealed that providers frequently selected the generic “Pediatric Unit” in the electronic medical record, often misaligning with the patient’s actual post-operative care needs. This led to inappropriate unit assignments and subsequent unplanned transfers.
Method: Using a Plan-Do-Study-Act framework, data were presented to multidisciplinary stakeholders. Providers received education on accurate post-operative disposition planning. The electronic medical record was modified to include a specific “ICU - Pediatric” option to improve accuracy in level of care designation during surgical scheduling. This change has since been adopted across the southeast division.
Results/Conclusions: Unscheduled post-operative pediatric intensive care admissions with incorrect initial postings decreased from 75% in April 2024 to 18% by December 2024. Overall, the rate of unscheduled post-operative admissions improved to 42% post-intervention but remained above the benchmark.
Implications for Practice:This initiative demonstrates that electronic medical record modifications, targeted education, and multidisciplinary collaboration, can reduce unscheduled pediatric intensive care unit admissions. Accurate disposition planning enhances patient safety, optimizes resource use, and decreases strain on critical care services.
Document Type
Oral/Podium Presentation
Publication Date
11-12-2025
Improving Post-Operative Disposition Accuracy to Decrease Unscheduled Pediatric Intensive Care Unit Admissions
Background: Unscheduled post operative admissions to the pediatric intensive care unit strain hospital resources due to the inability to plan for staffing, services, supplies, and bed availability. Understanding trends in these admissions is critical to improving efficiency, timeliness and quality of care. Unscheduled cardiovascular admissions are associated with longer length of stay and increased mortality. Additionally, among unscheduled admissions after anesthesia, 33% are predictable and 19% preventable, indicating intervention opportunities.
Local Problem: At our institution, 52% of post-operative admissions to the pediatric intensive care unit were unscheduled, significantly higher than the Virtual Pediatric Systems comparison group rate of 34% (p < 0.0001). Internal review revealed that providers frequently selected the generic “Pediatric Unit” in the electronic medical record, often misaligning with the patient’s actual post-operative care needs. This led to inappropriate unit assignments and subsequent unplanned transfers.
Method: Using a Plan-Do-Study-Act framework, data were presented to multidisciplinary stakeholders. Providers received education on accurate post-operative disposition planning. The electronic medical record was modified to include a specific “ICU - Pediatric” option to improve accuracy in level of care designation during surgical scheduling. This change has since been adopted across the southeast division.
Results/Conclusions: Unscheduled post-operative pediatric intensive care admissions with incorrect initial postings decreased from 75% in April 2024 to 18% by December 2024. Overall, the rate of unscheduled post-operative admissions improved to 42% post-intervention but remained above the benchmark.
Implications for Practice:This initiative demonstrates that electronic medical record modifications, targeted education, and multidisciplinary collaboration, can reduce unscheduled pediatric intensive care unit admissions. Accurate disposition planning enhances patient safety, optimizes resource use, and decreases strain on critical care services.
Affiliations
Atrium Health WFB Brenner Children's Hospital