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; Justin Lockwood; Tina Sosa; Orsola Gawronski; Vinay Nadkarni; Monica Kleinman; Maya Dewan; Kamal Abulebda; Diane Atkins; Shilpa Balikai; Marc Berg; Robert Berg; Matthew S. Braga; Corinne Buysse; Adam Cheng; Andrea Christoff; Kelly Corbett; Allan DeCaen; Destiny LaShoto; Gabry deJong; Jimena del Castillo; Maya Dewan; Aaron Donoghue; Ivie Esangbedo; Stuart Friess; Sandeep Gangadharan; Orsola Gawronski; Jonathan Gilleland; Heather Griffis; James Gray; Helen Harvey; Ilana Harwayne-Gidansky; Sarah Haskell; Jennifer Hayes; Kiran Heber; Betsy Hunt; Takanari Ikeyama; Priti Jani; Monica Kleinman; Lynda Knight; Hiroshi Kurosawa; Kasper Glerup Lauridsen; Tara Lemoine; Tensing Maa; Elizabeth Masse; Luz Marina Mejia; Yee Hui Mok; Ryan Morgan; Vinay Nadkarni; Sholeen Nett; Abhay Ranganathan; Amanda O'Halloran; Michelle Olson; Gene Ong; Andrea Maxwell; Tia Raymond; Joan Roberts; Anita Sen; Sophie Skellet; Daniel Stromberg; Felice Su; Robert Sutton; Todd Sweberg; Oscar Tegg; Ken Tegtmeyer; Alexis Topjian; Claire Hanson; Javier Urbano Villaescusa; Ichiro Watanabe; Denise Welsby; Jesse Wenger; Heather Wolfe; Andrea Yeo; Pricilla Yu; Rhea Vidrine; Gim Tan; Afsaneh Pirzadeh; Angela Wratney; Kimberly DiMaria

doi:10.1002/jhm.13224

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, Justin Lockwood, Tina Sosa, Orsola Gawronski, Vinay Nadkarni, Monica Kleinman, Maya Dewan, Kamal Abulebda, Diane Atkins, Shilpa Balikai, Marc Berg, Robert Berg, Matthew S. Braga, Corinne Buysse, Adam Cheng, Andrea Christoff, Kelly Corbett, Allan DeCaen, Destiny LaShoto, Gabry deJongJimena del Castillo, Maya Dewan, Aaron Donoghue, Ivie Esangbedo, Stuart Friess, Sandeep Gangadharan, Orsola Gawronski, Jonathan Gilleland, Heather Griffis, James Gray, Helen Harvey, Ilana Harwayne-Gidansky, Sarah Haskell, Jennifer Hayes, Kiran Heber, Betsy Hunt, Takanari Ikeyama, Priti Jani, Monica Kleinman, Lynda Knight, Hiroshi Kurosawa, Kasper Glerup Lauridsen, Tara Lemoine, Tensing Maa, Elizabeth Masse, Luz Marina Mejia, Yee Hui Mok, Ryan Morgan, Vinay Nadkarni, Sholeen Nett, Abhay Ranganathan, Amanda O'Halloran, Michelle Olson, Gene Ong, Andrea Maxwell, Tia Raymond, Joan Roberts, Anita Sen, Sophie Skellet, Daniel Stromberg, Felice Su, Robert Sutton, Todd Sweberg, Oscar Tegg, Ken Tegtmeyer, Alexis Topjian, Claire Hanson, Javier Urbano Villaescusa, Ichiro Watanabe, Denise Welsby, Jesse Wenger, Heather Wolfe, Andrea Yeo, Pricilla Yu, Rhea Vidrine, Gim Tan, Afsaneh Pirzadeh, Angela Wratney, Kimberly DiMaria

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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.

Original language	English
Pages (from-to)	1102-1108
Number of pages	7
Journal	Journal of hospital medicine
Volume	18
Issue number	12
DOIs	https://doi.org/10.1002/jhm.13224
State	Published - Dec 2023

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O'Halloran, A., Lockwood, J., Sosa, T., Gawronski, O., Nadkarni, V., Kleinman, M., Dewan, M., Abulebda, K., Atkins, D., Balikai, S., Berg, M., Berg, R., Braga, M. S., Buysse, C., Cheng, A., Christoff, A., Corbett, K., DeCaen, A., LaShoto, D., ... DiMaria, K. (2023). How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey. Journal of hospital medicine, 18(12), 1102-1108. https://doi.org/10.1002/jhm.13224

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

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.",

author = "Amanda O'Halloran and Justin Lockwood and Tina Sosa and Orsola Gawronski and Vinay Nadkarni and Monica Kleinman and Maya Dewan and Kamal Abulebda and Diane Atkins and Shilpa Balikai and Marc Berg and Robert Berg and Braga, {Matthew S.} and Corinne Buysse and Adam Cheng and Andrea Christoff and Kelly Corbett and Allan DeCaen and Destiny LaShoto and Gabry deJong and {del Castillo}, Jimena and Maya Dewan and Aaron Donoghue and Ivie Esangbedo and Stuart Friess and Sandeep Gangadharan and Orsola Gawronski and Jonathan Gilleland and Heather Griffis and James Gray and Helen Harvey and Ilana Harwayne-Gidansky and Sarah Haskell and Jennifer Hayes and Kiran Heber and Betsy Hunt and Takanari Ikeyama and Priti Jani and Monica Kleinman and Lynda Knight and Hiroshi Kurosawa and Lauridsen, {Kasper Glerup} and Tara Lemoine and Tensing Maa and Elizabeth Masse and Mejia, {Luz Marina} and Mok, {Yee Hui} and Ryan Morgan and Vinay Nadkarni and Sholeen Nett and Abhay Ranganathan and Amanda O'Halloran and Michelle Olson and Gene Ong and Andrea Maxwell and Tia Raymond and Joan Roberts and Anita Sen and Sophie Skellet and Daniel Stromberg and Felice Su and Robert Sutton and Todd Sweberg and Oscar Tegg and Ken Tegtmeyer and Alexis Topjian and Claire Hanson and Villaescusa, {Javier Urbano} and Ichiro Watanabe and Denise Welsby and Jesse Wenger and Heather Wolfe and Andrea Yeo and Pricilla Yu and Rhea Vidrine and Gim Tan and Afsaneh Pirzadeh and Angela Wratney and Kimberly DiMaria",

note = "Publisher Copyright: {\textcopyright} 2023 Society of Hospital Medicine.",

year = "2023",

month = dec,

doi = "10.1002/jhm.13224",

language = "English",

volume = "18",

pages = "1102--1108",

journal = "Journal of hospital medicine",

issn = "1553-5592",

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O'Halloran, A, Lockwood, J, Sosa, T, Gawronski, O, Nadkarni, V, Kleinman, M, Dewan, M, Abulebda, K, Atkins, D, Balikai, S, Berg, M, Berg, R, Braga, MS, Buysse, C, Cheng, A, Christoff, A, Corbett, K, DeCaen, A, LaShoto, D, deJong, G, del Castillo, J, Dewan, M, Donoghue, A, Esangbedo, I, Friess, S, Gangadharan, S, Gawronski, O, Gilleland, J, Griffis, H, Gray, J, Harvey, H, Harwayne-Gidansky, I, Haskell, S, Hayes, J, Heber, K, Hunt, B, Ikeyama, T, Jani, P, Kleinman, M, Knight, L, Kurosawa, H, Lauridsen, KG, Lemoine, T, Maa, T, Masse, E, Mejia, LM, Mok, YH, Morgan, R, Nadkarni, V, Nett, S, Ranganathan, A, O'Halloran, A, Olson, M, Ong, G, Maxwell, A, Raymond, T, Roberts, J, Sen, A, Skellet, S, Stromberg, D, Su, F, Sutton, R, Sweberg, T, Tegg, O, Tegtmeyer, K, Topjian, A, Hanson, C, Villaescusa, JU, Watanabe, I, Welsby, D, Wenger, J, Wolfe, H, Yeo, A, Yu, P, Vidrine, R, Tan, G, Pirzadeh, A, Wratney, A & DiMaria, K 2023, 'How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey', Journal of hospital medicine, vol. 18, no. 12, pp. 1102-1108. https://doi.org/10.1002/jhm.13224

TY - JOUR

T1 - How do we detect and respond to clinical deterioration in hospitalized children? Results of the Pediatric Care BefOre Deterioration Events (CODE) survey

AU - O'Halloran, Amanda

AU - Lockwood, Justin

AU - Sosa, Tina

AU - Gawronski, Orsola

AU - Nadkarni, Vinay

AU - Kleinman, Monica

AU - Dewan, Maya

AU - Abulebda, Kamal

AU - Atkins, Diane

AU - Balikai, Shilpa

AU - Berg, Marc

AU - Berg, Robert

AU - Braga, Matthew S.

AU - Buysse, Corinne

AU - Cheng, Adam

AU - Christoff, Andrea

AU - Corbett, Kelly

AU - DeCaen, Allan

AU - LaShoto, Destiny

AU - deJong, Gabry

AU - del Castillo, Jimena

AU - Dewan, Maya

AU - Donoghue, Aaron

AU - Esangbedo, Ivie

AU - Friess, Stuart

AU - Gangadharan, Sandeep

AU - Gawronski, Orsola

AU - Gilleland, Jonathan

AU - Griffis, Heather

AU - Gray, James

AU - Harvey, Helen

AU - Harwayne-Gidansky, Ilana

AU - Haskell, Sarah

AU - Hayes, Jennifer

AU - Heber, Kiran

AU - Hunt, Betsy

AU - Ikeyama, Takanari

AU - Jani, Priti

AU - Kleinman, Monica

AU - Knight, Lynda

AU - Kurosawa, Hiroshi

AU - Lauridsen, Kasper Glerup

AU - Lemoine, Tara

AU - Maa, Tensing

AU - Masse, Elizabeth

AU - Mejia, Luz Marina

AU - Mok, Yee Hui

AU - Morgan, Ryan

AU - Nadkarni, Vinay

AU - Nett, Sholeen

AU - Ranganathan, Abhay

AU - O'Halloran, Amanda

AU - Olson, Michelle

AU - Ong, Gene

AU - Maxwell, Andrea

AU - Raymond, Tia

AU - Roberts, Joan

AU - Sen, Anita

AU - Skellet, Sophie

AU - Stromberg, Daniel

AU - Su, Felice

AU - Sutton, Robert

AU - Sweberg, Todd

AU - Tegg, Oscar

AU - Tegtmeyer, Ken

AU - Topjian, Alexis

AU - Hanson, Claire

AU - Villaescusa, Javier Urbano

AU - Watanabe, Ichiro

AU - Welsby, Denise

AU - Wenger, Jesse

AU - Wolfe, Heather

AU - Yeo, Andrea

AU - Yu, Pricilla

AU - Vidrine, Rhea

AU - Tan, Gim

AU - Pirzadeh, Afsaneh

AU - Wratney, Angela

AU - DiMaria, Kimberly

PY - 2023/12

Y1 - 2023/12

N2 - 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.

AB - 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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U2 - 10.1002/jhm.13224

DO - 10.1002/jhm.13224

M3 - Article

C2 - 37861210

AN - SCOPUS:85174386529

SN - 1553-5592

VL - 18

SP - 1102

EP - 1108

JO - Journal of hospital medicine

JF - Journal of hospital medicine

IS - 12

ER -

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

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