Rationale
Code blue and RRT events were included
because they represent unexpected
and/or critical deterioration
characteristics in some hospitalized
pediatric patients. In addition, assessment
and communication processes
are similar. At Children’s, employees,
patients, parents, and families may unconditionally
request urgent medical
assistance (RRT) for a patient who is
perceived to be in distress without advance
consultation with housestaff or
the patient’s attending physicians. We
tested the sensitivity of PEWS in this
population as an objective tool to predict
critical deterioration and to support
structured communication of patient
status between team members.
RRT and code blue events provide measurable
outcomes that we hope to reduce
with implementation of PEWS.
This was a retrospective study design
of cases before implementation of
PEWS. It is the only design that is not
contaminated by interventions in response
to PEWS. Once PEWS is implemented,
it becomes unclear as to
whether the event would have occurred
as a result of interventions that
are responses to critical PEWS.