Pediatric Continuity Care Intensivist

This randomized controlled trial will implement and evaluate the effects of a pediatric
continuity care intensivist (CCI) program. The study will evaluate how effective the modified
communication training for providers is to perform this new role. The primary outcome for the
study is whether a CCI will affect several patient level outcomes for patients who have been
admitted to the PICU longer than 7 days. Patient length of stay, hospital acquired
conditions, time to limitations of interventions and new medical technology will be assessed
comparing the intervention and usual care arms. The study will also determine the impact of
the CCI program on parent/family satisfaction with provider communication and decision-making
for their child.

Inclusion Criteria:

CCI Provider

1. Pediatric Intensive Care Unit Attending Physician who volunteers to serve in the role of
CCI.

Usual Care (UC) Provider

1. Any Pediatric Intensive Care Unit Attending Physician who is not enrolled as a CCI.

Parent-Patient Dyads

1. Parent/guardian of a child who has been admitted to the Children's Hospital of
Philadelphia (CHOP) PICU for ≥7 days after onset of the study

2. Parent/guardian ≥ 18 years old

3. Parent/guardian is English-speaking

4. Child <18 years old at time of enrollment

5. Child has been admitted to the PICU at CHOP for ≥7 days following onset of study

6. Patients are also eligible if, at the time the study is initiated, they have been in
the PICU for less than seven days

Exclusion Criteria:

CCI Provider

1. Any medical care provider who is not an attending physician (e.g., Pediatric critical
care residents, nurses, and fellows)

UC Provider

1. Any medical care provider who is not an attending physician (e.g., Pediatric critical
care residents, nurses, and fellows)

2. Attending physician who is enrolled in the study as a CCI

Parent-Patient Dyads

1. Parent or guardian who has previously participated in the CCI study in a previous
hospitalization (in either usual care or intervention arm)

2. Parent or guardian of a child who has already been hospitalized in the PICU >7 days at
the onset of the study.

3. Child ≥18 years of age at time of enrollment

4. Child is an emancipated minor.

5. Child has previously participated in the CCI study in a previous PICU stay (in either
usual care or intervention arm)

6. Child has been hospitalized in the PICU >7 days at the onset of the study

7. Child already has a "primary" attending

8. Child has a sibling that has already been enrolled in the study. This child will be
ineligible for the study but will be assigned to the same care as the child who is or
was enrolled in the study.