Quality and Safety in Acute Paediatrics

This research stream focuses on improving the recognition, response, and outcomes of serious illness in children presenting to acute healthcare settings, with a particular emphasis on emergency care, patient safety systems, and child death review. Led by Professor Simon Craig and Dr Erin Mills, this program of work spans large-scale observational studies, health systems research, and translational quality improvement initiatives across Australia and internationally. The overarching goal is to better understand how and why children deteriorate in healthcare settings—and how systems can be redesigned to prevent harm. Recent work has demonstrated that caregiver concern for clinical deterioration is strongly associated with critical illness in children, even outperforming traditional physiological markers such as abnormal vital signs . This has led to growing interest in embedding the “voice of the caregiver” within early warning systems and escalation pathways, as part of a broader shift towards patient- and family-centred safety systems. Key research themes include: *Recognition of deterioration and diagnostic error Identifying children at risk of unrecognised serious illness, including those with subtle or evolving presentations. Projects may involve large ED datasets, linked administrative data, and structured case review methodologies. *Caregiver concern and patient-centred safety systems Understanding how families detect early signs of deterioration, and how healthcare systems can better integrate caregiver input into clinical decision-making and escalation processes. *Child death review and learning systems Examining how deaths, critical illness, and serious adverse events in children are reviewed across jurisdictions, with the aim of improving consistency, transparency, and impact of recommendations at a system level. *Resuscitation and emergency care improvement Improving systems of care for critically unwell children in the emergency department, including early recognition, escalation pathways, and optimisation of acute interventions. *Health systems and data integration Developing approaches to link datasets (e.g. emergency, inpatient, ICU, and mortality data) to better understand trajectories of deterioration and identify missed opportunities for intervention. Projects may include prospective cohort studies, multicentre audits, qualitative work with families and clinicians, and policy-focused research. Many projects are embedded within active national and international collaborations, including paediatric emergency research networks. This stream is well suited to students and trainees interested in paediatric emergency medicine, patient safety, health services research, or systems improvement, and offers opportunities to contribute to work with direct clinical and policy impact.