Characteristics of Pediatric Rapid Response Systems: Results From a Survey of PRIS Hospitals.

TitleCharacteristics of Pediatric Rapid Response Systems: Results From a Survey of PRIS Hospitals.
Publication TypeJournal Article
Year of Publication2021
AuthorsLockwood JM, Ziniel SI, Bonafide CP, Brady PW, O'Leary ST, Reese J, Wathen B, Dempsey AF
JournalHosp Pediatr
Date Published2021 Jan 25
ISSN2154-1671
Abstract

BACKGROUND: Many hospitals use rapid response systems (RRSs) to identify and intervene on hospitalized children at risk for deterioration.

OBJECTIVES: To describe RRS characteristics across hospitals in the Pediatric Research in Inpatient Settings (PRIS) network.

METHODS: We developed the survey through a series of prospective respondent, expert, and cognitive interviews. One institutional expert per PRIS hospital ( = 109) was asked to complete the web survey. We summarized responses using descriptive statistics with a secondary analysis of univariate associations between RRS characteristics and perceived effectiveness.

RESULTS: The response rate was 72% (79 of 109). Respondents represented diverse hospital types and were primarily physicians (97%) with leadership roles in care escalation. Many hospitals used an early warning score (77%) for identification with variable characteristics (46% automated versus 54% full or partially manual calculation; inputs included vital signs [98%], physical examination findings [88%], diagnoses [23%], medications [19%], and diagnostic tests [14%]). Few incorporated a validated prediction model (9%). Similarly, many RRSs used a rapid response team for intervention (93%) with variable team composition (respiratory therapists [94%], ICU nurses [93%], ICU providers [67%], and pharmacists [27%]). Some used the early warning score to trigger the rapid response team (50%). Only a few staffed a clinician to proactively surveil hospitalized children for risk of deterioration (18%), and these tended to be larger hospitals (annual admissions 12‚ÄČ000 vs 6000, = .007). Most responding experts stated their RRSs improved patient outcomes (92%).

CONCLUSIONS: RRS characteristics varied across PRIS hospitals.

DOI10.1542/hpeds.2020-002659
Alternate JournalHosp Pediatr
PubMed ID33495251