{
  "abstract": "The multifactorial challenges in assessing deterioration in children and escalating appropriately are common themes in cases of poor outcomes.1 Martha’s Rule is a patient safety initiative empowering families and carers to seek an urgent review if concerned about deterioration, following the tragic case of Martha Mills.2 Martha unfortunately died of sepsis following a traumatic pancreatic injury, amid ongoing concerns of deterioration from her parents which were not listened to.3 However, there is a paucity of evidence around best practice for communicating deterioration and involving families as partners, avoiding inappropriate escalation. Equity of access and catering for differing needs like learning disabilities and language is another challenge. A service designed to support early recognition and timely escalation could be highly beneficial, but faces challenges of staffing, finances and the wider safety culture in the NHS.4",
  "authors": [
    {
      "affiliations": [
        "Department of General Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Abigail Kiely"
    },
    {
      "affiliations": [
        "Paediatric Intensive Care, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK"
      ],
      "name": "Leanne George"
    },
    {
      "affiliations": [
        "Paediatric Intensive Care, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK"
      ],
      "name": "Davinder Singh"
    },
    {
      "affiliations": [
        "Paediatric Intensive Care, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK"
      ],
      "name": "Ramesh Kumar"
    },
    {
      "affiliations": [
        "Department of General Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Elizabeth Evans"
    }
  ],
  "title": "A step ahead of Martha’s Rule: evaluation of a parent initiated paediatric escalation pathway",
  "uid": "069bbc28-15ec-50c5-83df-c49b83f741dc"
}