Impact of introducing an electronic physiological surveillance system on hospital mortality

BMJ Quality and Safety

Volumn 24, Issue 1, 2015, Pages 10-20

  Schmidt, Paul E ^a   Meredith, Paul ^a   Prytherch, David R ^a,b   Watson, Duncan ^c   Watson, Valerie ^c   Killen, Roger M ^d   Greengross, Peter ^d,e   Mohammed, Mohammed A ^f   Smith, Gary B ^g  

^a PORTSMOUTH HOSPITALS NHS TRUST   (United Kingdom)

^b UNIVERSITY OF PORTSMOUTH   (United Kingdom)

^c UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST   (United Kingdom)

^d Learning Clinic   (United Kingdom)

^e IMPERIAL COLLEGE HEALTHCARE NHS TRUST   (United Kingdom)

^f UNIVERSITY OF BRADFORD   (United Kingdom)

^g BOURNEMOUTH UNIVERSITY   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; COMPUTER PROGRAM; DATA ANALYSIS; DEVICES; DISEASE SEVERITY; ELECTRONIC MEDICAL RECORD; ELECTRONIC PHYSIOLOGICAL SURVEILLANCE SYSTEM; GENERAL HOSPITAL; HOSPITAL PATIENT; HUMAN; MAJOR CLINICAL STUDY; MEDICAL DOCUMENTATION; MORTALITY; OBSERVATIONAL STUDY; PATIENT MONITORING; PROCESS CONTROL; VITAL SIGN; WIRELESS COMMUNICATION; CLINICAL TRIAL; ENGLAND; FEMALE; HOSPITAL MORTALITY; MALE; MIDDLE AGED; MULTICENTER STUDY; NURSING; PERSONAL DIGITAL ASSISTANT; PHYSIOLOGIC MONITORING; POINT OF CARE SYSTEM; PROCEDURES; REPRODUCIBILITY; RETROSPECTIVE STUDY; TRENDS;

AGED; COMPUTERS, HANDHELD; ENGLAND; FEMALE; HOSPITAL MORTALITY; HOSPITALS, GENERAL; HUMANS; MALE; MIDDLE AGED; MONITORING, PHYSIOLOGIC; POINT-OF-CARE SYSTEMS; REPRODUCIBILITY OF RESULTS; RETROSPECTIVE STUDIES; VITAL SIGNS;

EID: 84921688900     PISSN: 20445415     EISSN: None     Source Type: Journal    
DOI: 10.1136/bmjqs-2014-003073     Document Type: Article

References (51)

1. National Confidential Enquiry into Patient Outcomes and Death. An acute problem?. London: National Confidential Enquiry into Patient Outcome and Death, 2005.
2. National Patient Safety Agency. Safer care for the acutely ill patient: learning from serious incidents. London: NPSA, 2007.
3. National Patient Safety Agency. Recognising and responding appropriately to early signs of deterioration in hospitalised patients. London: NPSA, 2007.
4. National Institute for Health and Clinical Excellence. Acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital. London: NICE clinical guideline No. 50, 2007.
5. National Confidential Enquiry into Patient Outcomes and Death. Time to Intervene? A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardiorespiratory arrest. London: National Confidential Enquiry into Patient Outcome and Death, 2012.
6. Smith GB. In-hospital cardiac arrest: Is it time for an inh-ospital 'chain of prevention'? Resuscitation 2010;81:1209-11.
7. DeVita MA, Smith GB, Adam S, et al. Consensus conference on the afferent limb: identifying hospitalised patients in crisis. Resuscitation 2010;81:375-82.
8. Evans D, Hodgkinson B, Berry J. Vital signs in hospital patients: a systematic review. Int J Nurs Stud 2001;38:643-50.
9. Wheatley I. The practice of taking level 1 patient observations. Int Crit Care Nurs 2006;22:1115-21.
10. Chen J, Hillman K, Bellomo R, et al. The impact of introducing medical emergency team system on the documentations of vital signs. Resuscitation 2009;80:35-43.
11. Hands C, Reid E, Meredith P, et al. Patterns in the recording of vital signs and early warning scores - time of day, day of week. BMJ Q Saf 2013;22:719-26.
12. Buist M, Stevens S. Patient bedside observations: what could be simpler? BMJ Q Saf 2013;22:699-701.
13. Hillman K, Chen J, Cretikos M, et al. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet 2005;365:2091-7.
14. Smith AF, Oakey RJ. Incidence and significance of errors in a patient 'track and trigger' system during an epidemic of Legionnaires' disease: retrospective case note analysis. Anaesthesia 2006;61:222-8.
15. Prytherch D, Smith G, Schmidt P, et al. Calculating early warning scores - A classroom comparison of pen and paper and hand-held computer methods. Resuscitation 2006;70:173-8.
16. Mohammed M, Hayton R, Clements G, et al. Improving accuracy and efficiency of early warning scores in acute care. Br J Nurs 2009;18:18-24.
17. Edwards MMH, Van Leuvan C, Mitchell I. Modified early warning scores: inaccurate summation or inaccurate summation of score? Crit Care 2010;14(Suppl 1):S88.
18. Preece MHW, Hill A, Horswill MS, et al. Supporting the detection of patient deterioration: Observation chart design affects the recognition of abnormal vital signs. Resuscitation 2012;83:1111-18.
19. Christofidis MJ, Hill A, Horswill MS, et al. Observation charts with overlapping blood pressure and heart rate graphs do not yield the performance advantage that health professionals assume: an experimental study. J Adv Nurs 2014;70:610-24.
20. Smith GB, Prytherch DR, Schmidt P, et al. Hospital-wide physiological surveillance - a new approach to the early identification and management of the sick patient. Resuscitation 2006;71:19-29.
21. Jones DA, DeVita MA, Bellomo R. Rapid - response teams. N Engl J Med 2011;365:139-46.
22. Smith GB, Osgood VM, Crane S. ALERT - a multiprofessional training course in the care of the acutely ill adult patient. Resuscitation 2002;52:281-6.
23. Smith GB, Prytherch DR, Schmidt P, et al. Review and performance evaluation of aggregate weighted 'track and trigger' systems. Resuscitation 2008;77:170-9.
24. Understanding HSMRs. A toolkit on hospital standardised mortality ratios. Version 6. London: Dr. Foster Intelligence, 2011.
25. Dr Foster Intelligence. Real Time Monitoring (RTM). Enabling providers and commissioners to benchmark and monitor clinical outcomes. http://drfosterintelligence.co.uk/solutions/nhs-hospitals/real-time-monitoring-rtm (accessed 22 Jan 2014).
26. Benneyan JC. Use and interpretation of statistical quality control charts. Int J Qual Health Care1998;10:69-73.
27. Grigg O, Farewell VT, Spiegelhalter DJ. Use of risk-adjusted CUSUM and RSPRT charts for monitoring in medical contexts. Stat Methods Med Res 2003;12:147-70.
28. Grunkemeier GL, Jin R, Wu Y. Cumulative sum curves and their prediction limits. Ann Thorac Surg 2009;87:361-4.
29. Bellomo R, Bagshaw SM. Evidence-based medicine: classifying the evidence from clinical trials - the need to consider other dimensions. Crit Care 2006;10:232.
30. Buist M. The rapid response team paradox: why doesn't anyone call for help? Crit Care Med 2008;36:634-6.
31. Shearer B, Marshal S, Buist MD, et al. What stops hospital clinical staff from following protocols? An analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus Australian metropolitan healthcare service. BMJ Qual Saf 2012;21:569-75.
32. Bates DW. The Effects of Health Information Technology on Inpatient Care. Arch Intern Med 2009;169:105-7.
33. Brown CA, Lilford RJ. The stepped wedge trial design: a systematic review. BMC Med Res Methodol 2006;6:54.
34. Aylin P. Understanding hospital mortality indicators. SEPHIG Meeting 2013. http://www.sepho.org.uk/viewResource.aspx?id=14609 (accessed 22 Jan 2014).
35. Robb E, Jarman B, Suntharalingam G, et al. Using care bundles to reduce in-hospital mortality: quantitative survey. BMJ 2010;340:c1234.
36. Rafferty AM, Clarke SP, Coles J, et al. Outcomes of variation in hospital nurse staffing in English hospitals: Cross-sectional analysis of survey data and discharge records. Int J Nurs Studies 2007;44:175-82.
37. Sedgwick P. The Hawthorne effect. BMJ 2012;344:d8262.
38. Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003;348:2526-34.
39. Bates DW, Kuperman GJ, Wang S, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc 2003;10:523-30.
40. Watkinson PJ, Barber VS, Price JD, et al. A randomised controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients. Anaesthesia 2006;61:1031-9.
41. Hravnak M, Edwards L, Clontz A, et al. Defining the incidence of cardiorespiratory instability in patients in step-down units using an electronic integrated monitoring system. Arch Intern Med 2008;168:1300-8.
42. Hravnak M, DeVita MA, Clontz A, et al. Cardiorespiratory instability before and after implementing an integrated monitoring system. CCM 2011;39:65-72.
43. Taenzer AH, Pyke JB, McGrath SP, et al. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study. Anesthesiology 2010;112:282-7.
44. Bellomo R, Ackerman M, Bailey M, et al. Vital signs to identify, target, and assess level of care study (VITAL Care Study) investigators. A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards. CCM 2012;40:2349-61.
45. Brown H, Terrence J, Vasquez P, et al. Continuous monitoring in an inpatient medical-surgical unit: a controlled clinical trial. Am J Med 2014;127:226-32.
46. Huh JW, Lim C-M, Koh Y, et al. Activation of a medical emergency team using an electronic medical recording-based screening system. Crit Care Med 2014;42:801-8.
47. Jones S, Mullaly M, Ingleby S, et al. Bedside electronic capture of clinical observations and automated clinical alerts to improve compliance with an Early Warning Score protocol. Crit Care Resusc 2011;13:83-8.
48. Smith LB, Banner L, Lozano D, et al. Connected care: Reducing errors through automated vital signs data upload. Comput Inform Nurs 2009;27:318-23.
49. Gearing P, Olney CM, Davis K, et al. Enhancing patient safety through electronic medical record documentation of vital signs. J Healthc Inf Manag 2006;20:40-5.
50. Meccariello M, Perkins D, Quigley LG, et al. Vital Time Savings. Evaluating the use of an automated vital signs documentation system on a medical/surgical unit. JHIM 2010;24:46-51.
51. Fieler VK, Jaglowski T, Richards K. Eliminating errors in vital signs documentation. Comput Inform Nurs 2013;31:422-7.