Markham Stouffville pioneers Bedside PEWS

MARKHAM, Ont. – In May, Markham Stouffville Hospital – located northeast of Toronto – will launch an electronic “early warning” system to help prevent pediatric patients from getting sicker.

While the process is used in paper form at more than 30 hospitals around the world, Markham Stouffville will become the world’s first to use the electronic version of the Bedside Paediatric Early Warning System also known as BedsidePEWS.

“It’s pretty cool,” founder Dr. Chris Parshuram, a critical care doctor at the Hospital for Sick Children, told the Toronto Star. SickKids is partnering on the project with Markham Stouffville.

“It’s a testimony to Markham Stouffville’s willingness to be at the leading edge. What they want is to lead and provide the best care that will become the standard. I think they are leaders at the provincial level. The potential of the system as a screening tool for use across the province is massive.”

A doctor, nurse or other healthcare provider will enter a patient’s information, such as temperature, weight, heart rate and breathing rate, into a computer.

BedsidePEWS provides a score between 0 and 26, rating the child’s health, with higher scores being given to patients who are sicker.

The number isn’t as important as whether the score inches up over time, indicating the youngster is getting sicker, Markham Stouffville pediatrician, Dr. Jane Roberts (pictured), said.

“It’s easy to tell (the difference between) a kind of sick child and a very sick child. This helps with the subtleties between a kind of sick child and a getting sicker child. That’s harder to tell or predict,” she said.

“What BedsidePEWS does is, it identifies subtle changes in vital signs like heart rate, before maybe the clinicians, the nurses and even the doctors, might pick it up.”

The electronic version means doctors can access a patient’s status from any computer in the hospital rather than having to be on the ward or calling in for a paper update, Roberts said.

BedsidePEWS complements, not replaces, care provided by doctors and nurses, Parshuram stressed.

He likened it to a speedometer, a tool that helps motorists assess and correct their behaviour.

The system is helpful in a swamped healthcare system where providers are pulled in many directions, Parshuram said.

“The reality is the healthcare system is busy and what we need is a system that can help responsibly match the needs of individual children with the available services so that care can be prioritized,” he said.

Roberts agreed, adding the system also reassures parents their child is being well cared for.

“It is a safety mechanism because I can’t sit there the whole time and be there minute-to-minute and make changes,” she added.

“Sometimes it’s not good for the kid to make minute-to-minute changes. Sometimes, we do need to give them a chance to show us what they’re able to do.”