A real-time electronic physiology monitoring system signaled clinicians of patients' impending deterioration and was associated with a significant mortality reduction.BMJ Qual Saf. 2014 Sep 23; [Epub ahead of print].
Impact of introducing an electronic physiological surveillance system on hospital mortality.
Schmidt PE, Meredith P, Prytherch DR, et al. BMJ Qual Saf. 2014 Sep 23; [Epub ahead of print].Many patients show physiological signs of worsening for several hours prior to requiring more aggressive interventions and transfer to a higher level of care. Rapid response teams have been widely deployed to address this problem, but this approach is fundamentally reactive rather than proactive and has had mixed results so far. This time series study utilized an electronic physiological surveillance system—a real-timedecision support system based on patients' vital signs—embedded within the electronic medical record to provide guidance for clinicians in determining patients at risk for deterioration and optimizing treatment intensity. Implementation of the electronic physiological surveillance system was associated with a statistically significant reduction in mortality for a broad range of diagnoses at both hospitals. The results of this study illustrate the potential of novel information technology approaches for prospectively identifying patients at risk for clinical harm.
Improving quality and safety of care using "technovigilance": an ethnographic case study of secondary use of data from an electronic prescribing and decision support system.
Dixon-Woods M, Redwood S, Leslie M, Minion J, Martin GP, Coleman JJ. Milbank Q. 2013;91:424-454.
Implementing the Safety Thermometer tool in one NHS trust.
Buckley C, Cooney K, Sills E, Sullivan E. Br J Nurs. 2014;23:268-272.
Escalation of care in surgery: a systematic risk assessment to prevent avoidable harm in hospitalized patients.
Johnston M, Arora S, Anderson O, King D, Behar N, Darzi A. Ann Surg. 2014 May 30; [Epub ahead of print].
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Too Tight Control.
Rubin HR, Fajtova VT. AHRQ WebM&M [serial online]. May 2004.