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A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team.
MedLine Citation:
PMID:  24706596     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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. Journal of Hospital Medicine 2014. © 2014 Society of Hospital Medicine.
Authors:
Marin H Kollef; Yixin Chen; Kevin Heard; Gina N Larossa; Chenyang Lu; Nathan R Martin; Nelda Martin; Scott T Micek; Thomas Bailey
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-7
Journal Detail:
Title:  Journal of hospital medicine : an official publication of the Society of Hospital Medicine     Volume:  -     ISSN:  1553-5606     ISO Abbreviation:  J Hosp Med     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101271025     Medline TA:  J Hosp Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Society of Hospital Medicine.
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