Case for change: a standardised inpatient paediatric early warning system in England

Area of Science:

• Pediatric critical care
• Patient safety and quality improvement
• Clinical informatics

Background:

• Suboptimal outcomes and unintended harm occur in a subset of deteriorating hospitalized children due to delayed recognition and response.
• Regulatory agencies recommend paediatric early warning systems (PEWS) to address missed early signs of deterioration.
• Track and trigger tools (TTT), a component of PEWS, have been implemented heterogeneously in England with mixed evidence.

Purpose of the Study:

• To explain the rationale for implementing a standardized inpatient PEWS across England.
• To describe how this standardized PEWS integrates into a broader system-wide paediatric observations tracking system.
• To outline the collaborative effort by NHS England, Royal College of Paediatrics and Child Health, and Royal College of Nursing.

Main Methods:

• Review of existing literature and investigation into adverse events related to paediatric deterioration.
• Analysis of the implementation strategy for a standardized PEWS in England.
• Description of the integration of PEWS within a national paediatric observations tracking system.

Main Results:

• Rationale established for a standardized PEWS to improve early recognition and response to deterioration.
• A system-wide approach is being adopted to ensure consistent application of PEWS.
• Collaborative efforts are underway to enhance patient safety through improved monitoring.

Conclusions:

• A standardized inpatient PEWS is crucial for mitigating risks associated with paediatric clinical deterioration.
• The implementation aims to create a more robust and effective system for monitoring children in hospitals.
• This initiative represents a significant step towards enhancing patient safety and outcomes in paediatric care.