Implementation of the pediatric early warning scoring system on a pediatric hematology/oncology unit

Area of Science:

• Pediatric Hematology/Oncology
• Critical Care Medicine
• Patient Safety

Background:

• Pediatric Hematology/Oncology patients face ongoing risks from sepsis and acute events, despite overall outcome improvements.
• Timely recognition and intervention are crucial for managing clinical deterioration in this vulnerable population.
• Existing care pathways may present barriers to prompt escalation of care.

Purpose of the Study:

• To evaluate the impact of implementing a pediatric early warning scoring tool (PEWS) and a multidisciplinary action algorithm.
• To reduce barriers to timely referral for clinically deteriorating pediatric Hematology/Oncology patients.
• To improve multidisciplinary team communication and patient outcomes.

Main Methods:

• Implementation of a pediatric early warning scoring tool (PEWS) integrated with a multidisciplinary action algorithm.
• Application of the PEWS and algorithm within a dedicated pediatric Hematology/Oncology unit.
• Monitoring of key performance indicators related to patient deterioration and team response.

Main Results:

• The implemented PEWS and algorithm successfully removed barriers to timely patient referral.
• Multidisciplinary team communication was significantly enhanced.
• A more than threefold increase in the number of days between critical events (codes) was observed on the unit.

Conclusions:

• Pediatric early warning scoring tools, coupled with multidisciplinary action algorithms, are effective in improving patient safety in Hematology/Oncology.
• These interventions facilitate earlier recognition and management of clinical deterioration, leading to better patient outcomes.
• The successful implementation demonstrates a scalable model for enhancing critical care in pediatric oncology settings.