A prominent theme in this year’s review was recommendations concerning airway management and adherence to PALS standards within healthcare organizations. The PDRC also made recommendations for joint quality-of-care reviews between involved healthcare organizations. These joint reviews allow organizations involved in the care of the same patient to identify independent improvement opportunities as well as collaboratively address gaps in communication and care provision.

The OCC and PDRC believe that the clear understanding and accompanying data are valuable to provide a better understanding of paediatric deaths. The OCC continues to receive feedback from many parties about the value of the approach and the utility of the information. The OCC looks forward to the continued work with many, at the individual and organizational levels toward the shared goal of improving the health, safety and well‐being of Ontario’s children and youth.