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

• DOI: 10.1002/jhm.13224
• Publication Date: 2023-10-20T11:45:58Z
• Authors: Amanda O'Halloran; Justin Lockwood; Tina Sosa; Orsola Gawronski; Vinay Nadkarni; Monica Kleinman; Maya Dewan
• Keywords: Cross-Sectional Studies; SDG 3 - Good Health and Well-being; Clinical Deterioration; Surveys and Questionnaires; Humans; Child; Intensive Care Units, Pediatric; Child, Hospitalized

AbstractSystems 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.