Impact of an independent pediatric rapid response team on pediatric patient safety

Background:The pediatric rapid response system (pRRT) aims to detect early clinical deterioration in hospitalized pediatric patients and provide timely interventions to prevent critical outcomes.This study evaluates the 3-year operational outcomes and clinical effectiveness of Korea's first independent, specialist-led pRRT.Methods: A retrospective observational study was conducted on pediatric patients (<18 years) admitted to Severance Children's Hospital between January 2019 and September 2024.The pRRT, comprising a pediatric intensivist and a dedicated nurse, operated on weekdays during daytime hours.High-risk patients were identified using an early warning system.The primary outcomes were the incidence of cardiopulmonary resuscitation (CPR) in general wards and the rate of intensive care unit (ICU) transfers.Results: Since the pRRT was implemented in June 2021, 1,980 interventions were conducted.The CPR rate decreased from 8.2 to 4.1 per 1,000 patient-days between 2021 and 2023.The number of ICU transfers increased from 20 cases in 2021 to 63 cases in 2023.Key interventions included oxygen therapy, fluid resuscitation, and central venous catheter insertion.Notably, the use of high-flow nasal cannulas increased from 10 cases in 2021 to 47 cases in 2023. Conclusion:The introduction of an independent, specialist-led pRRT significantly reduced CPR incidence and increased ICU transfer rates, thereby improving patient safety.These findings highlight the necessity and effectiveness of pediatric-focused rapid response systems in the Korean healthcare environment and provide a foundation for further implementation and optimization.