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. 2023 Dec;18(12):1102-1108.
doi: 10.1002/jhm.13224. Epub 2023 Oct 20.

How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey

Amanda O'Halloran  1 , Justin Lockwood  2 , Tina Sosa  3   4   5 , Orsola Gawronski  6 , Vinay Nadkarni  1 , Monica Kleinman  7 , Maya Dewan  8 ; pediRES-Q Investigators
Collaborators, Affiliations

How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey

Amanda O'Halloran et al. J Hosp Med. 2023 Dec.

Abstract

Systems to detect and respond to deteriorating hospitalized children are common despite little evidence supporting best practices. Our objective was to describe systems to detect/respond to deteriorating hospitalized children at Pediatric Resuscitation Quality Collaborative (pediRES-Q) institutions. We performed a cross-sectional survey of pediRES-Q leaders. Questionnaire design utilized expert validation and cognitive interviews. Thirty centers (88%) responded. Most (93%) used ≥1 system to detect deterioration: most commonly, early warning scores (83%), watcher lists (55%), and proactive surveillance teams (31%). Most (90%) had a team to respond to deteriorating patients and the majority of teams could be activated by clinician or family concerns. Most institutions (90%) collect relevant data, including number of rapid responses (88%), arrests outside intensive care units (100%), and serious safety events (88%). In conclusion, most pediRES-Q institutions utilize systems to detect/respond to deteriorating hospitalized children. Heterogeneity exists among programs. Rigorous evaluation is needed to identify best practices.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Dr. Vinay Nadkarni serves as the President of the Society of Critical Care Medicine (SCCM). The views expressed in the manuscript are his and are not intended to represent the views of the SCCM. The remaining authors declare no conflict of interest

Figures

FIGURE 1
FIGURE 1
(a) Rapid response team and proactive surveillance team composition among respodent institutions and (b) rapid response team and proactive surveillance team activation triggers.
See this image and copyright information in PMC

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