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<p>Promptly recognising changes in an acutely unwell child’s condition is fundamental to prevent tragic outcomes. Western Australian (WA) healthcare facilities used inconsistent and varied paediatric early warning systems. To improve care consistency, a standardised ESCALATION system, inclusive of family involvement and sepsis recognition, was developed. Post-implementation audits offered limited insight into system fidelity, adoption, and integration. Furthermore, evaluation identified a need to tailor the ESCALATION system for Aboriginal families. WA Country Health Service (WACHS) provides healthcare to people who live in regional, rural and remote WA. Perth Children’s hospital (PCH) is the States specialist facility. This study will evaluate the scale-up and sustainability of the ESCALATION system into WACHS paediatric facilities and PCH, with a focus on strengthening Aboriginal family involvement. A pre-post, intervention study using implementation science methods, with two sub-studies. Sub-study one evaluates the ESCALATION system fidelity and adoption at six WACHS hospitals using audits, surveys, and focus groups with health professionals. Normalisation Process Theory will be used to understand practice integration and to develop and test solutions. Sub-study two uses participatory action approach at three WACHS sites and at PCH using surveys, interviews/focus groups with health professionals and Aboriginal families to co-design and test solutions to enhance Aboriginal family involvement in the ESCALATION system. Study findings will provide a comprehensive understanding of factors impacting the sustainability of the ESCALATION system ensuring it is used as intended in WA’s paediatric healthcare settings and meets the needs of all users including families, particularly Aboriginal families.</p>

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Pre-Post Intervention to Strengthen and Sustain the Paediatric ESCALATION System (The SPECS): Study Protocol

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月10日

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  • Eileen Boyle,
  • Pamela Laird,
  • Gavin D. Leslie,
  • Scott Stokes,
  • Jenni Andrew,
  • Jon Howard,
  • Melanie Robinson,
  • Tania Harris,
  • Fenella J. Gill

摘要

Promptly recognising changes in an acutely unwell child’s condition is fundamental to prevent tragic outcomes. Western Australian (WA) healthcare facilities used inconsistent and varied paediatric early warning systems. To improve care consistency, a standardised ESCALATION system, inclusive of family involvement and sepsis recognition, was developed. Post-implementation audits offered limited insight into system fidelity, adoption, and integration. Furthermore, evaluation identified a need to tailor the ESCALATION system for Aboriginal families. WA Country Health Service (WACHS) provides healthcare to people who live in regional, rural and remote WA. Perth Children’s hospital (PCH) is the States specialist facility. This study will evaluate the scale-up and sustainability of the ESCALATION system into WACHS paediatric facilities and PCH, with a focus on strengthening Aboriginal family involvement. A pre-post, intervention study using implementation science methods, with two sub-studies. Sub-study one evaluates the ESCALATION system fidelity and adoption at six WACHS hospitals using audits, surveys, and focus groups with health professionals. Normalisation Process Theory will be used to understand practice integration and to develop and test solutions. Sub-study two uses participatory action approach at three WACHS sites and at PCH using surveys, interviews/focus groups with health professionals and Aboriginal families to co-design and test solutions to enhance Aboriginal family involvement in the ESCALATION system. Study findings will provide a comprehensive understanding of factors impacting the sustainability of the ESCALATION system ensuring it is used as intended in WA’s paediatric healthcare settings and meets the needs of all users including families, particularly Aboriginal families.