Table 2.

Positive perception of care delivery during deterioration.

Theme		Provider	Example
Indirect impact of PEWS	Teamwork	Intradisciplinary
		UNOP Ward Physician	“Because it was late afternoon and many doctors were not present, I went downstairs and one of my colleagues was there helping us.”
		St. Jude Ward Nurse	“There are other nurses checking in on you, ‘Are you okay, can I do something for you? What can I bring you?’”
		Interdisciplinary
		UNOP Ward Nurse	“Here if there is something that the oncologists have given us confidence is that they have always taken us into account.”
		St. Jude ICU APP	“PEWS gets all the teams together and it makes them talk, and it makes them collaborate.”
	Experience with Deterioration	UNOP Ward Physician	“I think the intensive nursing staff has more experience in ventilating a child than the nurses who are on the ward.”
		St. Jude Ward Physician	“I’ve seen this happen like 15 to 20 times where a patient who is consistently tachycardic without a fever, they are automatically almost near the top of my list because that means they are about to go into hemodynamic instability, it’s just matter of time.”
Direct impact of PEWS	Early Awareness	UNOP ICU Physician	“Patients in general are detected early and in the ICU we have almost no patients detected late that require many more interventions or that the outcome is fatal.”
		St. Jude ICU Physician	“I have personally caught patients early and transferred them to the ICU early, there have been less [Rapid Response Teams] on the floor since it’s been implemented.”
	Effective Communication	UNOP Ward Physician	“It’s a method that helps at least the nursing team to see some … some signs of the patient and communicate to us any anomaly.”
		St. Jude Ward Nurse	“So, I feel like it gave our nurses on the floor a lot of empowerment to say, what I’m seeing and what I’m, you know, assessing, is real, and I’m concerned, and this is my objective data for it.”

St. Jude, St. Jude Children’s Research Hospital; UNOP, Unidad Nacional de Oncología Pediátrica; PEWS, Pediatric Early Warning System; APP, Advance Practice Provider; ICU, Intensive Care Unit.