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Barriers to calling for urgent assistance despite a comprehensive pediatric rapid response system.

Am J Crit Care

May 2014

Kathryn E. Roberts is a clinical nurse specialist in the Department of Nursing, The Children's Hospital of Philadelphia, Pennsylvania. Christopher P. Bonafide is an assistant professor of pediatrics in the Division of General Pediatrics at The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. Christine Weirich Paine is a senior clinical research assistant in the Division of General Pediatrics, The Children's Hospital of Philadelphia. Breah Paciotti is a senior research coordinator in the Mixed Methods Research Lab, University of Pennsylvania. Kathleen M. Tibbetts was a graduate research assistant in the Division of General Pediatrics, The Children's Hospital of Philadelphia at the time of this work and is now a senior research associate at GfK Healthcare, Blue Bell, Pennsylvania. Ron Keren is a professor of pediatrics and epidemiology at the Perelman School of Medicine at the University of Pennsylvania and an attending physician in the Division of General Pediatrics and chief quality officer at The Children's Hospital of Philadelphia. Frances K. Barg is an associate professor of family medicine and community health at the Perelman School of Medicine and an associate professor in the Department of Anthropology in the School of Arts and Sciences at the University of Pennsylvania. John H. Holmes is an associate professor of medical informatics in epidemiology, chair of the Graduate Group in Epidemiology and Biostatistics, and associate director of the Institute for Biomedical Informatics at the University of Pennsylvania Perelman School of Medicine.

Background: Rapid response systems (RRSs) aim to identify and rescue hospitalized patients whose condition is deteriorating before respiratory or cardiac arrest occurs. Previous studies of RRS implementation have shown variable effectiveness, which may be attributable in part to barriers preventing staff from activating the system.

Objective: To proactively identify barriers to calling for urgent assistance that exist despite recent implementation of a comprehensive RRS in a children's hospital.

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