Abstract 13306: The Pediatric Acute Care Cardiology Collaborative (PAC3) Hospital Acute Care Unit Survey: Results and Implications

IntroductionThe Pediatric Acute Care Cardiology Collaborative (PAC) was established in 2014 to understand systems and clinical practices in cardiac care delivered outside the intensive care unit with a focus on outcomes, quality improvement, and patient safety. An initial PAC project was a comprehensive survey to understand unit structure, practices, and resource utilization across the collaborative.MethodsThe survey consisted of 126 stem questions. Many questions had branching logic for positive responses leading to 412 total possible response fields. Questions were categorized into domainsdemographics, staffing, resources and therapies, and standard care practices. Five supplemental questions addressed patient and surgical volume variables. Responses were recorded and stored in a REDCap database.ResultsSurveys were completed by 31 (91%) of 34 member centers. A majority (19, 61%) of centers have a single, dedicated cardiac acute care unit (ACU), which is contiguous or on the same floor as the ICU in 15 (48%). A nurse staffing ratio of 3:1 is employed in 71% of centers and 26 (84%) reported having a resource nurse. Centralized wireless rhythm monitoring is used in 26 (84%) centers with 14 (54%) staffed continuously. Table 1 shows the use of various high-acuity therapies. Figure 1 illustrates the varied use of protocols and procedures in this population.ConclusionsThe PAC hospital survey is the most thorough effort to understand systems and clinical care practices in the cardiac ACU to date. It demonstrates notable heterogeneity and varied practice patterns amongst units. Further study may identify a combination of structure and services that can enhance efficiency, safety, and patient outcomes.