Title

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

Year of Publication

2021

Date Published

2021 Jan 25

ISSN Number

2154-1671

Abstract

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

<p><strong>OBJECTIVES: </strong>To describe RRS characteristics across hospitals in the Pediatric Research in Inpatient Settings (PRIS) network.</p>

<p><strong>METHODS: </strong>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.</p>

<p><strong>RESULTS: </strong>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 12 000 vs 6000, = .007). Most responding experts stated their RRSs improved patient outcomes (92%).</p>

<p><strong>CONCLUSIONS: </strong>RRS characteristics varied across PRIS hospitals.</p>

DOI

10.1542/hpeds.2020-002659

Alternate Title

Hosp Pediatr

PMID

33495251

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