A Quality Improvement Initiative to Reduce Unnecessary Rapid Responses Using Early Warning Scores

OBJECTIVES: The Pediatric Early Warning Score (PEWS) is an evidence-based tool that allows early collaborative assessment and intervention for a rapid response team (RRT) activation. goal of our quality improvement initiative was to reduce the percentage unnecessary RRT activations by 50% over 2 years without increasing PICU transfers or compromising patient safety timely evaluation. METHODS: A PEWS system replaced preexisting vital signs–based pediatric criteria modified through plan-do-study-act cycles. Unnecessary activations, total activation rate, PICU, clinical interventions performed per RRT, missed rate were compared between periods. Likert scale surveys administered measure satisfaction with each modification. RESULTS: There significant decrease in from 33% 3.5% after implementation modified-PEWS systems (P < .05). decreased 22.6 13.3 1000 care days .05), changes transfer rates. Physicians reported improved nursing communication accuracy Nursing management autonomy CONCLUSIONS: have been effective means identifying deteriorating patients reducing activations. new fosters collaboration at bedside prevent acute deterioration, perform interventions, ultimately improve outcomes.