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Health

Canberra doctors, opposition call for immediate change to hospital warning system for children

Doctors and the ACT opposition are calling for urgent changes to the hospital warning system used in the care of seriously ill children.

The calls follow the death of five-year-old Rozalia Spadafora, who died at Canberra Hospital in July while waiting to be taken to Sydney for treatment.

Having arrived a day earlier, Rozalia's family say that although she was pale, lethargic and swollen around her face, she was left unattended for long periods without staff observing her vital signs.

The ACT Coroner is now investigating Rozalia's death.

Canberra Liberals health spokeswoman Leanne Castley said the hospital's paediatric early warning system (PEWS) should be updated to monitor other sick children more closely.

She said a "single trigger system" — monitoring changes in vital signs such as heart rate, blood pressure and temperature — could increase the frequency of observations and calls for extra care.

"Sick children can deteriorate extremely quickly, and it is clear we can do better in identifying that," she said.

The Australian Medical Association's ACT branch has also recommended improving PEWS.

Its president, Walter Abhayaratna, said NSW and Victoria had effective single trigger systems, and the ACT could learn from them.

"Canberra Health Services uses a [PEWS] that has an aggregate score, which can sometimes miss out on those children who could be identified earlier using a single point to identify they're deteriorating," Professor Abhayaratna said.

Existing system is not a barrier: minister

ACT Health Minister Rachel Stephen-Smith said the hospital's PEWS already allowed staff to escalate care if a single vital sign changed.

"We hear from clinicians that sometimes the observations aren't necessarily telling you that there's a problem, but your gut is," she said.

"You know as an experienced clinician that there is something wrong with your patient, and the current system enables clinicians — whether they're nurses or doctors — to escalate to some more senior care or some more specialised care.

"Jurisdictions across Australia have … different systems in place because there is no one identified and recognised best-practice system."

Ms Stephen-Smith said the ACT was rolling out a new digital health record system in November, which would integrate the existing PEWS.

"The key is making sure the system is well understood and well used," she said.

However, Professor Abhayaratna argued the ACT system could be improved, and the  digital record rollout was the time to change it.

He said the existing PEWS could be tweaked during the rollout and then, perhaps early next week, work could begin to replace it with a more sensitive system.

"I could understand that approach being a safe one," he said.

The government said it was seeking to improve how the ACT's hospitals treated children and young people.

Ms Stephen-Smith has announced an independently chaired expert panel to oversee that work.

The panel would examine Canberra's forecast health needs, consider which services to expand, and improve the integration of primary, specialist, acute and interstate clinical services.

"The expert panel will bring further transparency and accountability to this work by sharing information with the community as we progress," the minister said.

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