P0186 / #1642: MORTALITY REDUCTION BASED “ BABY JAGUAR “ QUALITY INITIATIVE AND PEDIATRIC ACUTE EXTENSIVE CARE IN PUBLIC HOSPITAL GUATEMALA

Abstract

Aims & Objectives: Demostrate the impact of quality initiative to promote attention of pediatric acute patients admitted to pediatric intensive care unit and medical wards Hospital General San Juan de Dios in Guatemala City, Guatemala. Methods: Since 2014 in Pediatrics in Hospital General San Juan de Dios, a increase of admissions to PICU, improve attention based early recognition, rapid response team and acute patient approach outside the PICU. Crew resource management and quality assesment initiative were developed based respiratory therapist, pediatric hospitalist program, mechanical ventilation, monitoring and decison making widespread in wards as the same in PICU are promoted. Measure number of admissions and mortality per year. Results: Since 2014 the PICU increases the attention from 22 to 50 patients in Invasive or Non Invasive Ventilation and Acute Care based in Extensive Care and Rapid Response Team. A Simulation Center, the quality initiative “ Baby Jaguar “ allow the attention of more than 10,873 patients admitted since 2014 to 2019. The number of patients rises based in extensive care, deteriorating child approach and rapid response team. The crew with pediatrics residents, nurses, respiratory therapist, psychologist, nutritionist and pediatrics hospitalist reachs global reduction mortality of 36 % per year. (717 vrs 454). No intervention in construction or equipment; the main intervention was change the attention model. Conclusions: The pediatric acute care, deteriorating child and extensive care approach based in quality assurance improve the results in mortality based in monitoring, decision making and rapid response team in public hospital in resource strain public hospital