Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.

<h4>Background</h4>Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the...

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Autores principales:	Lorena Micheline Alves Silva, Diego Marques Moroço, José Paulo Pintya, Carlos Henrique Miranda
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3b3b51dc6bc447f3a4be8593ac151d0c
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spelling	oai:doaj.org-article:3b3b51dc6bc447f3a4be8593ac151d0c2021-12-02T20:07:37ZClinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.1932-620310.1371/journal.pone.0259577https://doaj.org/article/3b3b51dc6bc447f3a4be8593ac151d0c2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259577https://doaj.org/toc/1932-6203<h4>Background</h4>Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the modified early warning score (MEWS) in high-risk wards offering ED support is associated with decreased in-hospital mortality rate.<h4>Methods</h4>A before-and-after cross-sectional study compared in-hospital mortality rates before and after implementation of an RRT triggered by the MEWS ≥4 in two wards of a tertiary hospital that offer ED support.<h4>Results</h4>We included 6863 patients hospitalized in these wards before RRT implementation from July 2015 through June 2017 and 6944 patients hospitalized in these same wards after RRT implementation from July 2018 through June 2020. We observed a statistically significant decrease in the in-hospital mortality rate after intervention, 449 deaths/6944 hospitalizations [6.47% (95% confidence interval (CI) 5.91%- 7.07%)] compared to 534 deaths/6863 hospitalizations [7.78% (95% CI 7.17-8.44)] before intervention; with an absolute risk reduction of -1.31% (95% CI -2.20 --0.50).<h4>Conclusion</h4>RRT trigged by the MEWS≥4 in high-risk wards that offer ED support was found to be associated with a decreased in-hospital mortality rate. A further cluster-randomized trial should evaluate the impact of this intervention in this setting.Lorena Micheline Alves SilvaDiego Marques MoroçoJosé Paulo PintyaCarlos Henrique MirandaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259577 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lorena Micheline Alves Silva Diego Marques Moroço José Paulo Pintya Carlos Henrique Miranda Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.
description	<h4>Background</h4>Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the modified early warning score (MEWS) in high-risk wards offering ED support is associated with decreased in-hospital mortality rate.<h4>Methods</h4>A before-and-after cross-sectional study compared in-hospital mortality rates before and after implementation of an RRT triggered by the MEWS ≥4 in two wards of a tertiary hospital that offer ED support.<h4>Results</h4>We included 6863 patients hospitalized in these wards before RRT implementation from July 2015 through June 2017 and 6944 patients hospitalized in these same wards after RRT implementation from July 2018 through June 2020. We observed a statistically significant decrease in the in-hospital mortality rate after intervention, 449 deaths/6944 hospitalizations [6.47% (95% confidence interval (CI) 5.91%- 7.07%)] compared to 534 deaths/6863 hospitalizations [7.78% (95% CI 7.17-8.44)] before intervention; with an absolute risk reduction of -1.31% (95% CI -2.20 --0.50).<h4>Conclusion</h4>RRT trigged by the MEWS≥4 in high-risk wards that offer ED support was found to be associated with a decreased in-hospital mortality rate. A further cluster-randomized trial should evaluate the impact of this intervention in this setting.
format	article
author	Lorena Micheline Alves Silva Diego Marques Moroço José Paulo Pintya Carlos Henrique Miranda
author_facet	Lorena Micheline Alves Silva Diego Marques Moroço José Paulo Pintya Carlos Henrique Miranda
author_sort	Lorena Micheline Alves Silva
title	Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.
title_short	Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.
title_full	Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.
title_fullStr	Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.
title_full_unstemmed	Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.
title_sort	clinical impact of implementing a rapid-response team based on the modified early warning score in wards that offer emergency department support.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/3b3b51dc6bc447f3a4be8593ac151d0c
work_keys_str_mv	AT lorenamichelinealvessilva clinicalimpactofimplementingarapidresponseteambasedonthemodifiedearlywarningscoreinwardsthatofferemergencydepartmentsupport AT diegomarquesmoroco clinicalimpactofimplementingarapidresponseteambasedonthemodifiedearlywarningscoreinwardsthatofferemergencydepartmentsupport AT josepaulopintya clinicalimpactofimplementingarapidresponseteambasedonthemodifiedearlywarningscoreinwardsthatofferemergencydepartmentsupport AT carloshenriquemiranda clinicalimpactofimplementingarapidresponseteambasedonthemodifiedearlywarningscoreinwardsthatofferemergencydepartmentsupport
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Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support.

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