Research collaboration

Dynamic Electronic Tracking and Escalation to reduce Critical Care Transfers (DETECT)

This £1.2m innovative, collaborative (NIHRi4[1]) study is the first large study of its kind in children in the UK to evaluate the effectiveness of an electronic physiological surveillance system to help detect clinical deterioration in children. The system incorporates both an age-specific Paediatric Early Warning Score (PEWS) and the National Institute for Health and Clinical Excellence (NICE) sepsis screening guidance.

Its importance is such that it was one of very few studies that stayed live throughout the COVID-19 pandemic.

DETECT is based at Alder Hey Children’s Hospital where staff are using electronic hand-held devices to record patients’ vital signs including breathing rate, effort of breathing, oxygen saturation, oxygen requirement, heart rate, blood pressure, capillary refill time, temperature and nurse or parental concerns. The recorded data automatically calculates a paediatric early warning score (PEWS), which categorises the risk of developing serious illness into low, medium, high or critical.

The early identification of clinical deterioration in children is an ongoing challenge, but by using smarter and connected technology it is hoped that deterioration is picked up earlier and time-critical interventions can be implemented promptly. The system provides automated alerts about the sickest children and includes the ability to escalate concerns direct to the clinical team, without the nurse leaving the patient’s bedside. Push notification of laboratory results helps to identify when a child might have sepsis, a serious illness associated with an overwhelming response to infection.

Interim analysis of data is revealing positive trends and outcomes.

In July 2020, we took the chance to talk to some of the DETECT team.

• Gerri Sefton, the Co-Chief Investigator for DETECT and the PEWS lead at Alder Hey talks about how vital DETECT is in supporting patient safety. View Gerri’s mini interview.
• Professor Enitan Carrol, the Co-Chief Investigator for DETECT and an expert in sepsis from the Institute of Infection and Global Health at the University of Liverpool, talks about the benefits the system could bring to children’s treatment. View Enitan’s mini interview.
• Professor Bernie Carter, the lead for the qualitative component of DETECT, is based at Edge Hill University, talks about the importance of qualitative data in a study that has collected thousands and thousands of clinical quantitative data points. View Bernie’s mini interview.
• Caroline Lambert, the Research Data Administrator for DETECT, talks about some of the key management and administrative challenges she has faced and how she has overcome these. View Caroline’s mini interview.
• Sarah Siner, one of the Research Nurses for DETECT, explains how COVID-19 generated extra challenges in relation to recruitment and consent and how she tackled these to ensure that the study progressed during the pandemic. View Sarah’s mini interview.
• Holly Saron, the Research Fellow for the qualitative component of DETECT, is based at Edge Hill University. This is her first Research Fellow post and Holly talks of her impressions of being involved in a major clinical study and part of a large multi-disciplinary team. View Holly’s mini interview.
• Jacqueline Davis, is the Clinical Adoption Executive based at System C Healthcare. She talks of what aspects of implementing the system at Alder Hey and what she and her team have learned from being part of the DETECT study. View Jacqueline’s mini interview.

[1] National Institute for Health Research Invention for Innovation Programme.