Format

Send to

Choose Destination
J Hosp Med. 2014 Jul;9(7):424-9. doi: 10.1002/jhm.2193. Epub 2014 Apr 7.

A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team.

Author information

1
Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri.

Abstract

BACKGROUND:

Episodes of patient deterioration on hospital units are expected to increasingly contribute to morbidity and healthcare costs.

OBJECTIVE:

To determine if real-time alerts sent to the rapid response team (RRT) improved patient care.

DESIGN:

Randomized, controlled trial.

SETTING:

Eight medicine units (Barnes-Jewish Hospital).

PATIENTS:

Five hundred seventy-one patients.

INTERVENTION:

Real-time alerts generated by a validated deterioration algorithm were sent real-time to the RRT (intervention) or hidden (control).

MEASUREMENTS:

Intensive care unit (ICU) transfer, hospital mortality, hospital duration.

RESULTS:

ICU transfer (17.8% vs 18.2%; odds ratio: 0.972; 95% confidence interval [CI]: 0.635-1.490) and hospital mortality (7.3% vs 7.7%; odds ratio: 0.947; 95% CI: 0.509-1.764) were similar for the intervention and control groups. The number of patients requiring transfer to a nursing home or long-term acute care hospital was similar for patients in the intervention and control groups (26.9% vs 26.3%; odds ratio: 1.032; 95% CI: 0.712-1.495). Hospital duration (8.4 ± 9.5 days vs 9.4 ± 11.1 days; P = 0.038) was statistically shorter for the intervention group. The number of RRT calls initiated by the primary care team was similar for the intervention and control groups (19.9% vs 16.5%; odds ratio: 1.260; 95% CI: 0.823-1.931).

CONCLUSIONS:

Real-time alerts sent to the RRT did not reduce ICU transfers, hospital mortality, or the need for subsequent long term care. However, hospital length of stay was modestly reduced.

PMID:
24706596
PMCID:
PMC4354800
DOI:
10.1002/jhm.2193
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Frontline Medical Communications Inc Icon for PubMed Central
Loading ...
Support Center