Design and setting
Multinational survey initiated by the POKER consortium (Paediatric Oncology Kids in Europe Research group), endorsed by the European Society of Paediatric and Neonatal Intensive Care (ESPNIC).
We developed a web-based survey with domains based on prior studies demonstrating potential structure–outcome links in critical care and previously developed questionnaires.10-13 Additional questions were designed by the POKER consortium. The survey was constructed in accordance with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).14 The first draft of the questionnaire was discussed in January 2021. After several rounds of review and piloting to assess the usability and technical functionality of the electronic questionnaire by the POKER consortium, the final survey included the following domains: hospital and PICU type and bed capacity, PICU staffing patterns, hospital policies on the use of early warning scores and rapid response teams, presence of regular multidisciplinary clinical rounds, clinical pathways and protocols, regular meetings between oncologists and intensivists (i.e. formal meetings between the attending oncologist and intensivist to discuss care planning and setting of goals), oncologist participation during PICU multidisciplinary rounds, PICU admission policies for children with cancer, regular debriefing and administrative multidisciplinary meetings, and family visiting policies. The survey inquired practice outside the COVID-pandemic regulations. The full survey is shown in the additional supporting information.
Between February and June 2021, the members of the POKER consortium representing 11 European countries approached PICU directors or representatives in their country by E-mail or via established networks and invited experienced colleagues to participate in the survey. To avoid duplicates only one representative for each PICU was contacted. The questionnaire was distributed online via SurveyMonkey. As this survey was based on voluntary participation without collecting sensitive data, an Institutional Review Board did not review this study. By partaking in the survey, participants consented to the use of their data for the purpose of the study.