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Review of the Acuity Scoring Systems for the Pediatric Intensive Care Unit and Their Use in Quality Improvement

University of California, Davis Medical School, Department of Pediatrics, Section of Critical Care Medicine, University of California Davis Children's Hospital, Sacramento, CA, jpmarcin{at}ucdavis.edu

Murray M. Pollack, MD, FCCM

George Washington University School of Medicine, The Center for Hospital Based Specialties, and Critical Care Medicine, Children's National Medical Center, Washington, DC

Acuity scoring systems quantitate the severity of clinical conditions and stratify patients according to presenting patient condition. In the pediatric intensive care unit, the complexity and number of clinical scoring systems are increasing as their applications for clinicians, health services researches, and quality improvement broaden. This article is a review of acuity scoring systems for the pediatric intensive care unit, including examples of scoring systems available, the methods used in assessing these tools, the ways in which these systems are used, and the utility of acuity scoring systems in accurate benchmarking. It is anticipated that with increasing health care costs and competition and increased focus on medical error reduction and quality improvement, the demands for risk-adjusted outcomes and institutional benchmarking will increase; therefore, as clinicians, academicians, and administrators, it is imperative that we be knowledgeable of the methods and applications of these acuity scoring systems to ensure their quality and appropriate use.

Key Words: acuity scoring systems • critical care • intensive care • pediatrics • quality of care • quality improvement • benchmarking • mortality • severity of illness

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