Christina L. Cifra

Diagnosis-related handoffs for inter-facility transfers to the pediatric intensive care unit

OBJECTIVES: Inter-facility transfers to the pediatric intensive care unit (PICU) increase the risk of patient harm from communication breakdowns. We previously developed I-PASS-to-PICU, a structured inter-facility handoff program to improve information exchange during these trans...

Variation in In-Hospital Emergency Transfer Rates Across Pediatric Hospitals

BACKGROUND: Clinical deterioration with late escalation, termed emergency transfer (ET), is a key safety metric. However, national benchmarking is limited by variable definitions. We sought to estimate pooled ET rates and assess variation across pediatric hospitals. METHODS: We p...

Beyond ‘diagnostic error’: an ethnography of resilient behaviours and system adaptations in paediatric outpatient diagnosis

Background Improving paediatric diagnosis by addressing errors (Safety-I) is insufficient for diagnostic excellence. Resilience engineering’s approach to understanding adaptations to achieve success in everyday work may elucidate how individuals and systems manage diagnostic comp...