Complex decision making in an intensive care environment: Perceived practice versus observed reality.

Rationale: Advancing our understanding of how decisions are made in cognitively, socially and technologically complex hospital environments may reveal opportunities to improve healthcare delivery, medical education and the experience of patients, families and clinicians.

Aims And Objectives: Explore factors impacting clinician decision making in the Boston Children's Hospital Cardiac Intensive Care Unit.

Methods: A convergent mixed methods design was used.

Development and validation of a multivariable prediction model in pediatric liver transplant patients for predicting intensive care unit length of stay.

Background: Liver transplantation is the life-saving treatment for many end-stage pediatric liver diseases. The perioperative course, including surgical and anesthetic factors, have an important influence on the trajectory of this high-risk population. Given the complexity and variability of the immediate postoperative course, there would be utility in identifying risk factors that allow prediction of adverse outcomes and intensive care unit trajectories.

The truth Hertz-synchronization of electroencephalogram signals with physiological waveforms recorded in an intensive care unit.

The ability to synchronize continuous electroencephalogram (cEEG) signals with physiological waveforms such as electrocardiogram (ECG), invasive pressures, photoplethysmography and other signals can provide meaningful insights regarding coupling between brain activity and other physiological subsystems. Aligning these datasets is a particularly challenging problem because device clocks handle time differently and synchronization protocols may be undocumented or proprietary.We used an ensemble-based model to detect the timestamps of heartbeat artefacts from ECG waveforms recorded from inpatient bedside monitors and from cEEG signals acquired using a different device.

Effects of Unit Census and Patient Acuity Levels on Discussions During Patient Rounds.

Objectives: PICU teams adapt the duration of patient rounding discussions to accommodate varying contextual factors, such as unit census and patient acuity. Although studies establish that shorter discussions can lead to the omission of critical patient information, little is known about how teams adapt their rounding discussions about essential patient topics (i.e.