O-009a The Paediatric Observation Priority Score (pops): Outcomes Of 24000 Patients

Abstract

Background The Paediatric Observation Priority Score (POPS) (see Figure) has been designed as a triage tool and illness identification system to aid disposition and discharge decisions. Methods A unique data-collection method was set up whereby the key parameters of POPS were inputted onto a web-based data entry sheet. All children 0–15 presenting with any condition were included except those presenting straight to the resuscitation room. Data was collated with the hospital’s Emergency Department Information System and information from inpatient hospital systems. Results After data cleaning 24068 records were available for review between the period of August 2012 and December 2013. 2870 patients were admitted (11.9%). The majority of patients (16475) were POPS 0 (Table 1) and of these 794 (4.8%) were admitted to the hospital. Only 11 children discharged with POPS 0 returned to be admitted and required further definitive management. There was a correlation between initial POPS and average hospital stay (Pearsons correlation - 0.83, r2=0.92). The receiver operating characteristic (ROC) curve was 0.802 for POPS values sectioned into categories {0, 1–2, 3–4, 5–7 and 8+} at predicting admission. Conclusion POPS demonstrates utility as a patient safety system and a means to plan resources. The ROC is comparable with paediatric early warning scores systems utilised in Children’s Emergency Departments. There are significant risks in managing the acutely ill child but the introduction of POPS may assist in reducing unnecessary admission and prevent episodes of missed or incorrect diagnosis.