Removing barriers to pediatric early warning systems

Pediatric early warning systems (PEWS) are clinical assessment tools. They help staff quickly identify patients in the hospital whose condition is deteriorating. PEWS are not widely used in hospitals with limited resources. To understand why, scientists at St. Jude conducted a study. 

They looked at barriers to using PEWS in five hospitals in Latin America. The scientists interviewed doctors, nurses and administrators. The interviews used an implementation science framework that helped scientists obtain useful data from the interviews.

The study revealed barriers to using PEWS at staff, hospital and external levels. It also suggested ways to remove these barriers. This included engaging leadership early in the process and starting with a pilot to identify obstacles.

“There can be a blind spot, where we assume that if a system is effective, people will use it,” said Asya Agulnik, MD, St. Jude Global Critical Care Program director. “We know it is more complicated, especially if a hospital has resource limitations.”

“Wanting to improve care for patients and avoid these adverse events is a universal experience that can motivate use of PEWS,” Agulnik said.

The findings were published in JAMA Network Open.