Pediatric Early Warning Systems (PEWS) improve provider‐family communication from the provider perspective in pediatric cancer patients experiencing clinical deterioration. (21st September 2022)

• Record Type: Journal Article
• Authors: Gillipelli, Srinithya R.; Kaye, Erica C.; Garza, Marcela; Ferrara, Gia; Rodriguez, Mario; Soberanis Vasquez, Dora Judith; Mendez Aceituno, Alejandra; Antillón‐Klussmann, Federico; Gattuso, Jami S.; Mandrell, Belinda N.; Baker, Justin N.; Rodriguez‐Galindo, Carlos; Agulnik, Asya; Graetz, Dylan E.
• Is Part Of: Cancer medicine. Volume 12:Number 3(2023)
• Page Start: 3634
• Page End: 3643
• Publication Date: 2022-09-21
• Subjects: cancer management -- clinical cancer research -- clinical guidelines -- medical oncology -- pediatric cancer; 616.994005
• DOI: 10.1002/cam4.5210
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Background: Communication between providers and patients' families is an integral part of clinical care. Family concern is a validated component of Pediatric Early Warning Systems (PEWS); however, little is known about the impact of PEWS on provider‐family communication. Methods: Semi‐structured interviews were conducted with 83 ward and Pediatric Intensive Care Unit (PICU) providers involved in the care of patients with deterioration at two pediatric oncology hospitals of different resource levels: St. Jude Children's Research Hospital ( n = 42) in the United States and Unidad Nacional de Oncología Pediátrica (UNOP, n = 41) in Guatemala. Interviews were conducted in the participants' native language (English or Spanish), transcribed, and translated into English. Transcripts were coded by two researchers and analyzed for thematic content surrounding family communication and concern. Results: All participants recognized patients' families as a valuable part of the care team, particularly during events requiring escalation of care. Perceived barriers to communication included limited time spent at the bedside, and, at UNOP, language and literacy challenges which occasionally limited providers' ability to assess family concern and involve families in patient care. Despite these barriers, providers perceived PEWS improved communication by facilitating more interaction with families, allowing for relationship‐building, anticipatory guidance, and destigmatization of the PICU. PEWS assessments also allowed families to contribute to identification of deterioration. Conclusions: PEWS improve the quality of communication between providers and families by providing more opportunities for interaction, building relationships, and trust. These findings further support the use of PEWS in the care of children with cancer in hospitals of all resource‐levels. Abstract : In this qualitative analysis of provider interviews, we identify PEWS as facilitators of communication between providers and patient families in resource‐limited and high‐resource pediatric oncology hospitals. Our findings demonstrate that providers perceive the family concern component of PEWS allows greater inclusion of patient families as a part of the healthcare team.