The Paediatric Observation Priority Score: A System to Aid Detection of Serious Illness and Assist in Safe Discharge

Abstract

The Paediatric Observation Priority Score (POPS) is a bespoke assessment tool for use in Paediatric Emergency Departments incorporating traditional physiological parameters alongside more subjective observational criteria. Initial performance characteristics of POPS were analysed in a convenience sample of 936 presentations to ED. Triage on the basis of gut instinct parameters identified an additional 261 patients deemed of lowest acuity compared to analysis by physiology scores. Resource consumption increased with increasing acuity on presentation. POPS shows promise in assisting in the assessment process of children presenting to Emergency Departments. Inclusion of subjective triage criteria helps contextualise the physiological parameter scoring by using the experience of staff conducting triage. Initial interpretation of presenting physiology gives a more informed assessment of initial acuity, and thus is better able to identify a child who can be safely managed in the community. The system also allows for rapid detection of those most unwell.

Baseline Characteristics of the Paediatric Observation Priority Score in Emergency Departments outside Its Centre of Derivation

“…POPS uses a combination of physiological, behavioural, and known-risk parameters to generate a score of either 0, 1, or 2 ( Figure 1 ), giving a total score (0–16). POPS has undergone an initial single centre validation in a cohort of 942 patients [ 8 ], a larger group than any previous Emergency Department (ED) study [ 9 ]. Further local data on over 20,000 patients has demonstrated a relationship between length of admission and increasing POPS, with an increase when POPS > 4, and good safety profile [ 10 ].…”

Evaluation of COVID-19 assessment in emergency departments and ambulance services

“… PMEWS [8]  The Swine Flu Hospital Pathway [9]  NEWS2 [10]  The WHO decision-making algorithm for hospitalisation with pneumonia [11]  POPS [12]  COAST [13] The triage tools will be retrospectively applied to the data by the study statisticians. CURB-65 and PMEWS will be evaluated in adults only, NEWS2 will be evaluated in adults excluding pregnant women, POPS will be evaluated in children only.…”

Refining and testing the diagnostic accuracy of an assessment tool (PAT-POPS) to predict admission and discharge of children and young people who attend an emergency department: protocol for an observational study

“…For example, a study in 2008 of less than 400 patients demonstrated low sensitivity in predicting the need for admission [ 10 ]. The Pennine Acute Hospitals NHS Trust Paediatric Observation Priority Score (PAT-POPS) [ 11 ] is a modified version of the Paediatric Observation Priority Score (POPS) [ 12 ]. POPS was developed as a bespoke ED specific method of identifying children with potentially serious illnesses or infections while at the same time safely supporting staff in redirecting or discharging those who do not need ongoing immediate care.…”

“…Further data on over 20,000 patients has demonstrated a relationship between length of stay and increasing POPS score [ 14 ]. POPS has been shown to be beneficial in defining appropriate admission and also effective in defining safe discharge [ 12 – 15 ].…”