Description:  The Northern California Pediatric Intensive Care Network (PICN) is an informal consortium of all 13 Northern California Pediatric Intensive Care Units (PICUs); its mission is to advance and standardize the care of critically ill children in Northern California. This mission will be accomplished through the development of regional standards of care and best practice guidelines via exchange of policies, protocols, and procedure guidelines.  Policies, protocols, guidelines will be shared and discussions will occur on a dedicated PICN site within Salesforce Chatter.  The secure cloud database will allow member doctors and nurses to discuss a wide variety of management issues pertinent to their respective units, and ultimately collaborate to develop regional best practice guidelines. 

The existing PICN site provides a database for collection, distribution and discussion of:

• (Informal) Guidelines and Recommendations
• (Formal) Policies and Procedures
• Order Sets
• Templates
• Lectures/Talks

This database can be leveraged for broader clinical, research, and academic endeavors. However, as many bedside clinicians, particularly in non-academic institutions, are not actively involved in collaborative clinical research, engagement/participation in this database has been limited.  

We propose the following to facilitate broad-based clinician engagement through the collaborative development of regional best practice guidelines.

Participants will be identified from each member institution. Small groups will be created, each focused on one of four target clinical topics. Small groups will be able to internally distribute literature and serial drafts of their respective guidelines, while maintaining an ongoing dialogue visible to all group members.  This process would be completed over a 6 week period, resulting in a draft guideline to be shared during a breakout session at the annual PICN meeting at Children’s Hospital Oakland Research Institute on September 28, 2012.  As we will have four guidelines to present at the conclusion of the meeting, four breakout sessions would be held simultaneously in the morning, allowing audience members to participate in further discussion of the respective topic that s/he may be most interested in.  In the afternoon, one representative of each small group will present the final draft to the entire audience, with an opportunity for additional feedback.  (Each participating individual is a member of only ONE small group and works on only ONE guideline.)  At the conclusion of the meeting, each audience member leaves with four guidelines (which, at a maximum are PICN consensus statements, and at a minimum, are thorough reviews of the literature).  Guidelines are then available for application in our respective units.   We hope to close the meeting with an enhanced group appreciation of the power of social networking in developing best practices and standardizing patient care. Additionally, we will systematically seek feedback from our diverse group of clinician participants as to how to improve the Salesforce Chatter platform to be even more conducive to facilitating future collaborative endeavors.

Deliverables: Four evidence-based best practice guidelines developed through the Northern California PICN addressing common management issues in pediatric critical care, available and applicable to every Pediatric ICU in Northern California, with a primary goal of improving patient care efficacy and safety to all critically ill children in Northern California (with our collective ICUs admitting over 10,000 children per year).

Team:

Arup Roy-Burman, MD – Medical Director, PICU

Lindsay Lightbody, MA – Project Coordinator

Peter Oishi, MD - Director of Critical Care Quality, Patient Safety, and Clinical Program Initiatives

Each team member will devote an estimated 5 hours per week on this project.