Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study

Abstract Background Rapid response systems (RRSs) are essential components of patient safety systems; however, limited evidence exists regarding their effectiveness and optimal structures. We aimed to assess the activation patterns and outcomes of RRS implementation with/without a real-time automati...

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Autores principales:	Seung-Hun You, Sun-Young Jung, Hyun Joo Lee, Sulhee Kim, Eunjin Yang, SAVER team
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Rapid response team Clinical alarms Quality improvements Resuscitation Intensive care units Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/b1830f55d0f84626a38e5904604b495b
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spelling	oai:doaj.org-article:b1830f55d0f84626a38e5904604b495b2021-12-05T12:10:51ZIncorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study10.1186/s13049-021-00979-y1757-7241https://doaj.org/article/b1830f55d0f84626a38e5904604b495b2021-12-01T00:00:00Zhttps://doi.org/10.1186/s13049-021-00979-yhttps://doaj.org/toc/1757-7241Abstract Background Rapid response systems (RRSs) are essential components of patient safety systems; however, limited evidence exists regarding their effectiveness and optimal structures. We aimed to assess the activation patterns and outcomes of RRS implementation with/without a real-time automatic alerting system (AAS) based on electronic medical records (EMRs). Methods We retrospectively analyzed clinical data of patients for whom the RRS was activated in the surgical wards of a tertiary university hospital. We compared the code rate, in-hospital mortality, unplanned intensive care unit (ICU) admission, and other clinical outcomes before and after applying RRS and AAS as follows: pre-RRS (January 2013–July 2015), RRS without AAS (August 2015–November 2016), and RRS with AAS (December 2016–December 2017). Results In-hospital mortality per 1000 admissions decreased from 15.1 to 12.9 after RRS implementation (p < 0.001). RRS activation per 1000 admissions increased from 14.4 to 26.3 after AAS implementation. The severity of patients’ condition calculated using the modified early warning score increased from 2.5 (± 2.1) in the RRS without AAS to 3.6 (± 2.1) (p < 0.001) in the RRS with AAS. The total and preventable code rates and in-hospital mortality rates were comparable between the RRS implementation periods without/with AAS. ICU duration and mortality results improved in patients with RRS activation and unplanned ICU admission. The data of RRS non-activated group remained unaltered during the study. Conclusions Real-time AAS based on EMRs might help identify unstable patients. Early detection and intervention with RRS may improve patient outcomes.Seung-Hun YouSun-Young JungHyun Joo LeeSulhee KimEunjin YangSAVER teamBMCarticleRapid response teamClinical alarmsQuality improvementsResuscitationIntensive care unitsMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENScandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 29, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Rapid response team Clinical alarms Quality improvements Resuscitation Intensive care units Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Rapid response team Clinical alarms Quality improvements Resuscitation Intensive care units Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Seung-Hun You Sun-Young Jung Hyun Joo Lee Sulhee Kim Eunjin Yang SAVER team Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
description	Abstract Background Rapid response systems (RRSs) are essential components of patient safety systems; however, limited evidence exists regarding their effectiveness and optimal structures. We aimed to assess the activation patterns and outcomes of RRS implementation with/without a real-time automatic alerting system (AAS) based on electronic medical records (EMRs). Methods We retrospectively analyzed clinical data of patients for whom the RRS was activated in the surgical wards of a tertiary university hospital. We compared the code rate, in-hospital mortality, unplanned intensive care unit (ICU) admission, and other clinical outcomes before and after applying RRS and AAS as follows: pre-RRS (January 2013–July 2015), RRS without AAS (August 2015–November 2016), and RRS with AAS (December 2016–December 2017). Results In-hospital mortality per 1000 admissions decreased from 15.1 to 12.9 after RRS implementation (p < 0.001). RRS activation per 1000 admissions increased from 14.4 to 26.3 after AAS implementation. The severity of patients’ condition calculated using the modified early warning score increased from 2.5 (± 2.1) in the RRS without AAS to 3.6 (± 2.1) (p < 0.001) in the RRS with AAS. The total and preventable code rates and in-hospital mortality rates were comparable between the RRS implementation periods without/with AAS. ICU duration and mortality results improved in patients with RRS activation and unplanned ICU admission. The data of RRS non-activated group remained unaltered during the study. Conclusions Real-time AAS based on EMRs might help identify unstable patients. Early detection and intervention with RRS may improve patient outcomes.
format	article
author	Seung-Hun You Sun-Young Jung Hyun Joo Lee Sulhee Kim Eunjin Yang SAVER team
author_facet	Seung-Hun You Sun-Young Jung Hyun Joo Lee Sulhee Kim Eunjin Yang SAVER team
author_sort	Seung-Hun You
title	Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
title_short	Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
title_full	Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
title_fullStr	Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
title_full_unstemmed	Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
title_sort	incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b1830f55d0f84626a38e5904604b495b
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Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study

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