Pediatric Intensive Care Mortality Rate  (PRISM)

What is PRISM?

PRISM is a tool used to measure the Pediatric Risk of Mortality for patients receiving care in a pediatric intensive care unit.  The scoring focuses on the severity and intensity of illness during the first 12 hours that a child is in the intensive care unit.

What does Dayton Children's data show?

PRISM III data collected over the last four years shows that Dayton Children’s Pediatric Intensive Care Unit has seen an average Standard Mortality Ratio of 0.61 for a total of 2,194 patients admitted to the PICU. 

View Dayton Children's data

Deaths can be decreased for many reasons. We believe the following factors contribute to a continued decrease in mortality rates:

• Highly skilled board-certified pediatric intensivists in both critical care areas enhance the quality of care in these areas. Intensivists are physicians with special training in critical care medicine. Board-certified specialists also staff the newborn intensive care unit, providing specialized care to seriously ill and premature newborns.
• Accreditation of Level II Regional Pediatric Trauma Center and formation of trauma team consisting of a pediatric trauma surgeon, pediatric neurosurgeon, pediatric critical care doctor, pediatric emergency physician, pediatric orthopedist, pediatric respiratory therapist and may include a host of other doctors, nurses and staff trained to work exclusively with children.
• Successful efforts to encourage immunization of infants and children.
• The use of specialized equipment such as high-definition MRI and the fastest CT scanners that allow more accurate, faster diagnoses.
• Outreach activities that provide free bicycle helmets and car seat checks to ensure children are traveling safely. Through partnerships with Safe Kids and community partners, Dayton Children's is able to provide free health, safety and injury prevention activities throughout the hospital's 20-county region.

What does this mean for the children we care for?

• Simply stated, more children survive a very serious illness or injury than would have been expected based on the predicted risk of death.
• Low Standard Mortality Ratio’s in the pediatric intensive care unit (PICU) at Dayton Children’s demonstrates a better-than-predicted outcome for our critical patients when compared to all other institutions that participate in the PRISM data collection. 
• Children cared for at Dayton Children’s receive excellent care.

What other changes has Dayton Children's implemented to improve patient care and outcomes in the pediatric intensive care unit?

• Dayton Children’s has a team of intensivists who are specially trained and board certified in management of critically ill patients that require the high level of care available in the intensive care unit.
• Dayton Children’s has a newly redesigned pediatric intensive care unit that is family centered. Parents are encouraged to spend time with their child during this very stressful period. The rooms also have the latest equipment and are designed for the comfort of children and families.
• The physicians, nurses, and respiratory therapists have all received Pediatric Advanced Life Support certification training to help them manage a life-threatening event very quickly.
• Dayton Children's offers a Level II American College of Surgeons (ACS) accredited Regional Pediatric Trauma and Emergency Center for pediatric patients. As soon as a child is brought into the trauma center, they are surrounded by a team of surgeons, emergency physicians and intensivists who can provide expert pediatric trauma management.
• The use of specialized equipment such as high-definition MRI and the fastest CT scanners that allow more accurate, quicker diagnosing of conditions.
• Outreach activities that provide free bicycle helmets and car seat checks to ensure children are traveling safely.
   

Dayton Children’s history with PRISM

Dayton Children’s Pediatric Intensive Care Unit (PICU) collects data on all PICU admissions to the Critical Care Complex in order to predict mortality of that patient population. The PICUE (Pediatric ICU Evaluation) program launched in October 1996 and since July 2004 the PICUE database has been used at Dayton Children’s in collecting and analyzing data related to obtaining a PRISM III (Pediatric Risk Of Mortality) score. By collecting data such as diagnosis and age of the patient as well as blood pressure and blood oxygen levels Pediatric Intensive Care Units can predict the mortality rates of children cared for at their facility.