Introducing the ABC‑PRO framework

In this World Shared Practice Forum Podcast, Drs. Luregn Schlapbach and Janet Kelly-Geyer discuss the implementation and impact of the Airway, Breathing, Circulation - Plan, Risk, Options (ABC-PRO) handover tool in the Pediatric Intensive Care Unit. They discuss how a structured, proactive risk assessment during clinical handovers can reduce cardiac arrest rates and improve patient outcomes. They share perspectives on enhancing team situational awareness by anticipating high-risk events, identifying management strategies, and encouraging multidisciplinary participation in anticipatory care. Lastly, they highlight how the ABC-PRO framework advances overall patient safety in critical care settings. LEARNING OBJECTIVES - Understand the ABC-PRO tool’s function in reducing cardiac arrests and enhancing safety - Examine bedside team-based discussions around key patient risks during handovers using the ABC-PRO tool - Recognize the significance of interdisciplinary collaboration in patient management - Assess the potential for implementing similar handover improvements in diverse healthcare settings AUTHORS Luregn Schlapbach, MD, PhD Professor in Pediatric Intensive Care, Head of Department of Intensive Care and Neonatology, University Children`s Hospital Zurich Janet Kelly-Geyer, MBChB Senior PICU Consultant University Children's Hospital Zurich Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: March 24, 2026. ARTICLES REFERENCED - Catchpole KR, de Leval MR, McEwan A, et al. Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. Paediatr Anaesth. 2007;17(5):470-478. doi:10.1111/j.1460-9592.2006.02239.x - Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803-1812. doi:10.1056/NEJMsa1405556 - Riley CM, Diddle JW, Harlow A, et al. Shifting the Paradigm: A Quality Improvement Approach to Proactive Cardiac Arrest Reduction in the Pediatric Cardiac Intensive Care Unit. Pediatr Qual Saf. 2022;7(1):e525. Published 2022 Jan 21. doi:10.1097/pq9.0000000000000525 - Spaeder MC, Lee L, Miller C, Keim-Malpass J, Harmon WG, Kausch SL. Incidence of cardiac arrest following implementation of a predictive analytics display in a pediatric intensive care unit. Resusc Plus. 2025;21:100862. Published 2025 Jan 2. doi:10.1016/j.resplu.2024.100862 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/f7xr7vcxc6f4mhc9736tzpb/202603_WSP_Schlapbach___Kelly-Geyer_Transcript.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Schlapbach LJ, Kelly-Geyer JF, Burns JP. Reducing Cardiac Arrests in the PICU with ABC-PRO. 03/2026. OPENPediatrics. Online Podcast.