Validation questions influencing CSAT result
| Validation question | Response category | n (%) n=169 | CSAT mean | P value |
| Perceptions of PEWS | ||||
| Please rate the strength of the scientific evidence supporting PEWS implementation. | Weak +neither weak nor strong | 7 (4.2) | 4.05 | <0.001 |
| Strong | 56 (33.3) | 4.31 | ||
| Very strong | 105 (62.5) | 4.53 | ||
| NA | 1 | |||
| How important is PEWS to provide quality care to your patients? | Not very important (neither important nor unimportant +somewhat important) | 17 (10.1) | 3.95 | <0.001 |
| Very important | 152 (89.9) | 4.49 | ||
| PEWS Implementation process and use | ||||
| How difficult was the implementation of PEWS in your hospital? | Very difficult | 16 (9.6) | 4.21 | 0.054 |
| Somewhat difficult | 77 (46.1) | 4.44 | ||
| Neither easy nor difficult | 41 (24.6) | 4.40 | ||
| Somewhat easy | 24 (14.4) | 4.54 | ||
| Very easy | 9 (5.4) | 4.68 | ||
| NA | 2 | |||
| Our PEWS implementation team understands and uses quality improvement skills effectively. | Neither agree nor disagree | 6 (3.6) | 3.27 | <0.001 |
| Somewhat agree | 59 (34.9) | 4.23 | ||
| Strongly agree | 104 (61.5) | 4.61 | ||
| Regarding patients under my care, how often is PEWS used in their care? | None of the time +some of the time | 7 (4.1) | 4.17 | 0.002 |
| Most of the time | 22 (13.0) | 4.19 | ||
| All the time | 140 (82.8) | 4.49 | ||
| Centre culture and implementation climate | ||||
| Our resources (personnel, time, financial) were too tightly limited to improve care quality. | Strongly disagree | 16 (9.8) | 4.50 | 0.764 |
| Somewhat disagree | 41 (25.0) | 4.38 | ||
| Neither agree nor disagree | 34 (20.7) | 4.44 | ||
| Somewhat agree | 50 (30.5) | 4.41 | ||
| Strongly agree | 23 (14.0) | 4.50 | ||
| NA | 5 | |||
| Our clinical team has changed or created systems in the hospital that make it easier to provide high quality care. | Neither agree nor disagree | 20 (12.0) | 4.14 | <0.001 |
| Somewhat agree | 79 (47.3) | 4.29 | ||
| Strongly agree | 68 (40.7) | 4.68 | ||
| NA | 2 | |||
| We choose new processes of care that are more advantageous than the old to everyone involved (patients, clinicians, and our entire clinical team). | Strongly disagree +somewhat disagree | 3 (1.8) | 3.98 | <0.001 |
| Neither agree nor disagree | 17 (10.1) | 3.98 | ||
| Somewhat agree | 75 (44.6) | 4.31 | ||
| Strongly agree | 73 (43.5) | 4.68 | ||
| NA | 1 | |||
| The working environment in our clinical team is collaborative and cohesive, with shared sense of purpose, cooperation, and willingness to contribute to the common good. | Strongly disagree +somewhat disagree | 8 (4.7) | 4.16 | <0.001 |
| Neither agree nor disagree | 17 (10.1) | 4.19 | ||
| Somewhat agree | 73 (43.2) | 4.30 | ||
| Strongly agree | 71 (42.0) | 4.66 | ||
| Our clinical team has greatly improved quality of care in the past 12 months. | Somewhat disagree +neither agree nor disagree | 14 (8.3) | 4.03 | <0.001 |
| Somewhat agree | 66 (39.1) | 4.26 | ||
| Strongly agree | 89 (52.7) | 4.63 | ||
CSAT, Clinical Sustainability Assessment Tool; NA, not applicable; PEWS, Paediatric Early Warning System.