Pediatric early warning systems for children with cancer a success in Latin American Hospitals

Pediatric Early Warning Systems (PEWS)—bedside tools used by nurses to assess the health of hospitalized children and identify urgent medical issues—are not widely used in resource-limited hospitals, in part due to challenges with implementation. A recent article published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, reports on a successful collaboration to support implementation of a PEWS for children with cancer in Latin American hospitals.

In 2017, St. Jude Children’s Research Hospital partnered with pediatric oncology centers in Latin America to initiate Proyecto Escala de Valoración de Alerta Temprana (EVAT). St. Jude’s Asya Agulnik, MD, MPH, and her colleagues reported that from April 2017 to October 2021, 36 diverse hospitals from 13 countries in Latin America collectively managing more than 4,100 annual new pediatric cancer diagnoses successfully implemented PEWS through Proyecto EVAT.

Centers required an average of seven months to complete the implementation, and all of them—despite challenges of geography, language, and the COVID-19 pandemic—maintained high-quality PEWS use for up to 18 months after implementation. Across the 36 centers, more than 11,100 clinicians were trained in PEWS and more than 41,000 hospitalized children had PEWS used in their care.

“This is the first multicenter, multinational study reporting a successful implementation strategy to regionally scale-up PEWS,” said Dr. Agulnik. “The strategy used by Proyecto EVAT to regionally scale-up PEWS in these 36 resource-limited centers can be generalized to facilitate implementation of other interventions that improve patient outcomes in centers of all resource levels. We hope that lessons learned from this work can broadly inform future programs to promote adoption of interventions to improve cancer outcomes globally.”

Of note, a commentary published earlier this month in CANCER summarizes the top advances in pediatric cancer over the past 12 months. These pediatric cancer advances focus on solid tumor, brain tumor, leukemia, recurrent disease, and residual disease.

Additional Information

NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the Cancer News Room upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, [email protected]

Full Citations:

“Model for Regional Collaboration: Successful Strategy to Implement a Pediatric Early Warning System in 36 Pediatric Oncology Centers in Latin America.” Asya Agulnik, Alejandra Gonzalez Ruiz, Hilmarie Muniz-Talavera, Angela K. Carrillo, Adolfo Cárdenas, Maria F. Puerto-Torres, Marcela Garza, Tania Conde, Dora Judith Soberanis Vasquez, Alejandra Méndez Aceituno, Carlos Acuña Aguirre, Yvania Alfonso, Shillel Yahamy Álvarez Arellano, Deiby Argüello Vargas, Rosario Batista, Erika Esther Blasco Arriaga, Mayra Chávez Rios, María Elena Cuencio Rodríguez, Ever Amilcar Fing Soto, Wendy Gómez-García, Rafael H. Guillén Villatoro, María de Lourdes Gutiérrez Rivera, Martha Herrera Almanza, Yajaira V. Jimenez Antolinez, Maria Susana Juárez Tobias, Norma Araceli López Facundo, Ruth Angélica Martínez Soria, Kenia Miller, Scheybi Miralda, Roxana Morales, Natalia Negroe Ocampo, Alejandra Osuna, Claudia Pascual Morales, Clara Krystal Pérez Fermin, Carlos M. Pérez Alvarado, Estuardo Pineda, Carlos Andrés Portilla, Ligia Estefanía Rios López, Jocelyn Rivera, Arely Saraí Sagaón Olivares, Mélida Cristina Saguay Tacuri, Beatriz T. Salas Mendoza, Ivel Solano Picado, Verónica Soto Chávez, Isidoro Tejocote Romero, Daniel Tatay, Juliana Teixeira Costa, Erika Villanueva, Marielba Villegas Pacheco, Virginia R. McKay, Monika L. Metzger, Paola Friedrich, and Carlos Rodriguez-Galindo, on behalf of the EVAT Study Group. CANCER; Published Online: September 26, 2022 (DOI: 10.1002/cncr.34427). 

URL Upon Publication: http://doi.wiley.com/10.1002/cncr.34427  

About the Journal 
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. 

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