Chain of events needed to demonstrate an improved response to deterioration in inpatient children
| (1) Symptoms and signs of deterioration (‘calling criteria’) occur and are recognised by ward personnel; |
| (2) The ward personnel are empowered to call for assistance without delay, circumventing established hierarchies if necessary; |
| (3) A readily available urgent response occurs; and |
| (4) This response, along with associated interventions, improves outcomes |
Source: Joffe AR, Anton NR, Burkholder SC. Reduction in Hospital Mortality Over Time in a Hospital Without a Paediatric Medical Emergency Team: Limitations of Before-and-After Study Designs.20