Patient acuity rating: Quantifying clinical judgment regarding inpatient stability

Journal of Hospital Medicine

Volumn 6, Issue 8, 2011, Pages 475-479

  Edelson, Dana P ^a   Retzer, Elizabeth ^a   Weidman, Elizabeth K ^a,b   Woodruff, James ^a   Davis, Andrew M ^a   Minsky, Bruce D ^a   Meadow, William ^a   Hoek, Terry L Vanden ^a   Meltzer, David O ^a,c  

^a UNIVERSITY OF CHICAGO   (United States)

^b UNIVERSITY OF MINNESOTA MEDICAL SCHOOL   (United States)

^c UNIVERSITY OF CHICAGO   (United States)

Author keywords

Cardiac arrest; Clinical judgment; Rapid response team; Track and trigger

Indexed keywords

AREA UNDER THE CURVE; ARTICLE; CLINICAL DECISION MAKING; DIAGNOSTIC TEST ACCURACY STUDY; GENERAL CONDITION DETERIORATION; HEART ARREST; HOSPITAL PATIENT; HUMAN; INTENSIVE CARE UNIT; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; PATIENT TRANSPORT; PHYSICIAN; PRIORITY JOURNAL; PROSPECTIVE STUDY; RATING SCALE; RECEIVER OPERATING CHARACTERISTIC; RESIDENT; SENSITIVITY AND SPECIFICITY; SINGLE BLIND PROCEDURE; TEACHING HOSPITAL; UNIVERSITY HOSPITAL; ADULT; AGED; CLASSIFICATION; FEMALE; MIDDLE AGED; ORGANIZATION AND MANAGEMENT; PATIENT CARE; PROGNOSIS; RISK ASSESSMENT; STANDARD; STATISTICAL MODEL;

ADULT; AGED; CONTINUITY OF PATIENT CARE; FEMALE; HEART ARREST; HOSPITALS, TEACHING; HUMANS; INPATIENTS; INTENSIVE CARE UNITS; LOGISTIC MODELS; MALE; MIDDLE AGED; PATIENT TRANSFER; PROGNOSIS; PROSPECTIVE STUDIES; RISK ASSESSMENT;

EID: 80053917895     PISSN: 15535592     EISSN: 15535606     Source Type: Journal    
DOI: 10.1002/jhm.886     Document Type: Article

References (25)

1. Accreditation Council for Graduate Medical Education (ACGME). Task Force on Quality Care and Professionalism. Proposed standards: common program requirements. 2007. Available at: Accessed August 16, 2010.
2. Arora VM, Georgitis E, Siddique J, et al. Association of workload of on-call medical interns with on-call sleep duration, shift duration, and participation in educational activities. JAMA. 2008; 300( 10): 1146-1153.
3. Institute of Medicine (IOM). Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety. Report brief on resident duty hours: enhancing sleep, supervision, and safety. Washington, DC: National Academy Press; 2008. Available at: Accessed August 16, 2010.
4. Kuo PC, Douglas AR, Oleski D, Jacobs DO, Schroeder RA. Determining benchmarks for evaluation and management coding in an academic division of general surgery. J Am Coll Surg. 2004; 199( 1): 124-130.
5. Shen YJ. Applying the 3M all patient refined diagnosis related groups grouper to measure inpatient severity in the VA. Med Care. 2003; 41( 6): 103-110.
6. Norman G, Young M, Brooks L. Non-analytical models of clinical reasoning: the role of experience. Med Educ. 2007; 41( 12): 1140-1145.
7. Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. Qual Saf Health Care. 2005; 14( 6): 401-407.
8. Gandhi TK. Fumbled handoffs: one dropped ball after another. Ann Intern Med. 2005; 142( 5): 352-358.
9. Horwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. What are covering doctors told about their patients? Analysis of sign-out among internal medicine house staff. Qual Saf Health Care. 2009; 18( 4): 248-255.
10. Petersen LA, Brennan TA, O'Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994; 121( 11): 866-872.
11. Knaus WA, Harrell FE, Lynn J, et al. The SUPPORT prognostic model-objective estimates of survival for seriously ill hospitalized adults. Ann Intern Med. 1995; 122( 3): 191-203.
12. Meadow W, Frain L, Ren YY, Lee G, Soneji S, Lantos J. Serial assessment of mortality in the neonatal intensive care unit by algorithm and intuition: certainty, uncertainty, and informed consent. Pediatrics. 2002; 109( 5): 878-886.
13. Sinuff T, Adhikari NKJ, Cook DJ, et al. Mortality predictions in the intensive care unit: comparing physicians with scoring systems. Crit Care Med. 2006; 34( 3): 878-885.
14. Smith GB, Prytherch DR, Schmidt PL, Featherstone PI. Review and performance evaluation of aggregate weighted 'track and trigger' systems. Resuscitation. 2008; 77( 2): 170-179.
15. Kho A, Rotz D, Alrahi K, et al. Utility of commonly captured data from an EHR to identify hospitalized patients at risk for clinical deterioration. AMIA Annu Symp Proc. 2007: 404-408.
16. Jha AK, DesRoches CM, Campbell EG, et al. Use of electronic health records in U.S. hospitals. N Engl J Med. 2009; 360( 16): 1628-1638.
17. Lovett PB, Buchwald JM, Sturmann K, Bijur P. The vexatious vital: neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage. Ann Emerg Med. 2005; 45( 1): 68-76.
18. Laurila JV, Pitkala KH, Strandberg TE, Tilvis RS. Detection and documentation of dementia and delirium in acute geriatric wards. Gen Hosp Psychiatry. 2004; 26( 1): 31-35.
19. Hillman K, Parr M, Flabouris A, Bishop G, Stewart A. Redefining in-hospital resuscitation: the concept of the medical emergency team. Resuscitation. 2001; 48( 2): 105-110.
20. Hodgetts TJ, Kenward G, Vlachonikolis IG, Payne S, Castle N. The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resuscitation. 2002; 54( 2): 125-131.
21. Brilli RJ, Gibson R, Luria JW, et al. Implementation of a medical emergency team in a large pediatric teaching hospital prevents respiratory and cardiopulmonary arrests outside the intensive care unit. Pediatr Crit Care Med. 2007; 8( 3): 236-246.
22. Tibballs J, Kinney S, Duke T, Oakley E, Hennessy M. Reduction of paediatric in-patient cardiac arrest and death with a medical emergency team: preliminary results. Arch Dis Child. 2005; 90( 11): 1148-1152.
23. Guarisco S, Oddone E, Simel D. Time analysis of a general medicine service: results from a random work sampling study. J Gen Intern Med. 1994; 9( 5): 272-277.
24. Nerenz D, Rosman H, Newcomb C, et al. The on-call experience of interns in internal medicine. Medical Education Task Force of Henry Ford Hospital. Arch Intern Med. 1990; 150( 11): 2294-2297.
25. Dresselhaus TR, Luck J, Wright BC, Spragg RG, Lee ML, Bozzette SA. Analyzing the time and value of housestaff inpatient work. J Gen Intern Med. 1998; 13( 8): 534-540.