The importance of reducing unrecognized clinical deterioration events in hospitalized children on the journey to eliminate preventable harm is abundantly clear.1–4  Defining feasible and meaningful metrics to understand both the burden of this type of harm and the impact of targeted improvement interventions was a significant undertaking, particularly given the rarity of cardiopulmonary arrests in this population. Two validated metrics proximal to arrest were subsequently described: critical deterioration events and emergency transfers (ETs).1,3  Both metrics are associated with adverse outcomes for hospitalized children, including increased mortality, and improvement efforts such as rapid response systems are associated with a meaningful reduction in these events.1,6,7  However, ongoing challenges remain in pursuit of developing feasible, generalizable, and near real-time methods to track and proactively address deterioration. In the era of tremendous expansion in innovation and technology, electronic health record (EHR) automation,...

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