A Quality Improvement Project to Promote Interdisciplinary Communication Using the Pediatric Early Warning System

Area of Science:

• Pediatric Healthcare Quality Improvement
• Clinical Communication Strategies
• Patient Safety Systems

Background:

• Healthcare professionals initially lacked awareness and knowledge of the pediatric early warning system (PEWS).
• Interdisciplinary bedside huddles for critically scoring patients were infrequently performed, and documentation was lacking.
• Patients with critical scores faced a higher risk of clinical deterioration without adequate assessment documentation.

Purpose of the Study:

• To increase the mean rate of documented interdisciplinary bedside huddles for pediatric patients with critical scores.
• To improve the utilization and effectiveness of the pediatric early warning system (PEWS).
• To enhance communication and documentation for high-risk pediatric patients.

Main Methods:

• A quality improvement project was piloted on one pediatric hospital unit.
• Interventions included physician and nurse education, algorithm refinement, and promoting a shared understanding of PEWS.
• The primary outcome measure was the percentage of documented huddle notes for patients with critical scores.

Main Results:

• The mean baseline rate of documented huddles was 0%.
• After four months, the mean rate of documented huddles increased to 100%.
• This increase was associated with educational interventions and scoring algorithm improvements.

Conclusions:

• Multimodal interventions effectively increased documented huddles, enhancing PEWS implementation.
• Algorithm adjustments and personalized education fostered physician and nurse support for PEWS.
• Lessons learned can guide other institutions in implementing PEWS and promoting interdisciplinary communication.