ArticleJCO global oncology2020
Qualitative Study of Pediatric Early Warning Systems' Impact on Interdisciplinary Communication in Two Pediatric Oncology Hospitals With Varying Resources.
Article in JCO global oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Vital sign-based Early Warning Scores in low- and middle-income countries: a systematic review of clinical effectiveness and implementation challenges.Global health action · 2026Pooled it
- Health Care Providers' Perspectives on Early Warning Systems for Acute Respiratory Infections in Canada: Qualitative Study.JMIR public health and surveillance · 2026Article
- Strategies to improve healthcare team communication structure and quality in resource-variable childhood cancer hospitals (TeamTalk): a study protocol.Implementation science communications · 2025Article
- Implementing and evaluating a Paediatric Early Warning System (PEWS) at a National Referral Hospital in Botswana.BMJ paediatrics open · 2025Article
- Multilevel mortality risk factors among pediatric hematology-oncology patients with deterioration.Cancer · 2025Article
- Clinician perspectives on the multilevel impacts of Pediatric early warning systems (PEWS) in resource-variable hospitals.Frontiers in oncology · 2025Article
- [Infographic and pamphlet development creation to communicate EVAT to pediatric].Psicooncologia · 2024Article
- Documenting adaptations to an evidence-based intervention in 58 resource-variable pediatric oncology hospitals across implementation phases.Implementation science communications · 2024Article
- Connecting Clinical Capacity and Intervention Sustainability in Resource-Variable Pediatric Oncology Centers in Latin America.Global implementation research and applications · 2024Article
- Sustainability determinants of an intervention to identify clinical deterioration and improve childhood cancer survival in Latin American hospitals: the INSPIRE study protocol.Implementation science communications · 2023Article
- Effect of paediatric early warning systems (PEWS) implementation on clinical deterioration event mortality among children with cancer in resource-limited hospitals in Latin America: a prospective, multicentre cohort study.The Lancet. Oncology · 2023Article
- Stages of change: Strategies to promote use of a Pediatric Early Warning System in resource-limited pediatric oncology centers.Cancer medicine · 2023Article
- The COVID-19 Pandemic's impact on sustainability and expansion of a Pediatric Early Warning System in resource-limited hospitals.Cancer medicine · 2023Article
- Impact of hospital characteristics on implementation of a Pediatric Early Warning System in resource-limited cancer hospitals.Frontiers in oncology · 2023Article
- A new measure for multi-professional medical team communication: design and methodology for multilingual measurement development.Frontiers in pediatrics · 2023Article
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- Assessment of Barriers and Enablers to Implementation of a Pediatric Early Warning System in Resource-Limited Settings.JAMA network open · 2022Article
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Corrections and comments
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHospitalized pediatric oncology patients are at high risk of deterioration and require frequent interdisciplinary communication to deliver high-quality care. Pediatric early warning systems (PEWS) are used by hospitals to reduce deterioration, but it is unknown how these systems affect communication about patient care in high- and limited-resource pediatric oncology settings.
methodsThis qualitative study included semistructured interviews describing PEWS and subsequent team communication at 2 pediatric cancer centers, 1 in the United States and 1 in Guatemala. Participants included nurses, and frontline and intensive care providers who experienced recent deterioration events. Transcripts were coded and analyzed inductively using MAXQDA software.
resultsThe study included 41 providers in Guatemala and 42 providers in the United States (33 nurses, 30 ward providers, and 20 pediatric intensive care providers). Major themes identified include "hierarchy," "empowerment," "quality and method of communication," and "trigger." All providers described underlying medical hierarchies affecting the quality of communication regarding patient deterioration events and identified PEWS as empowering. Participants from the United States described the algorithmic approach to care and technology associated with PEWS contributing to impaired clinical judgement and a lack of communication. In both settings, PEWS sparked interdisciplinary communication and inspired action.
conclusionPEWS enhance interdisciplinary communication in high- and limited-resource study settings by empowering bedside providers. Traditional hierarchies contributed to negative communication and, in well-resourced settings, technology and automation resulted in lack of communication. Understanding contextual elements is integral to optimizing PEWS and improving pediatric oncology outcomes in hospitals of all resource levels.
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