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'Identifying the hospitalised patient in crisis' - A consensus conference on the afferent limb of Rapid Response Systems

Citation

DeVita, MA and Smith, GB and Adam, SK and Adams-Pizarro, I and Buist, MD and Bellomo, R and Bonello, R and Cerchiari, E and Farlow, B and Goldsmith, D and Haskell, H and Hillman, K and Howell, M and Hravnak, M and Hunt, EA and Hvarfner, A and Kellett, J and Lighthall, GK and Lippert, A and Lippert, FK and Mahroof, R and Myers, JS and Rosen, M and Reynolds, S and Rotondi, A and Rubulotta, F and Winters, B, 'Identifying the hospitalised patient in crisis' - A consensus conference on the afferent limb of Rapid Response Systems, Resuscitation, 81, (4) pp. 375-382. ISSN 0300-9572 (2010) [Refereed Article]


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DOI: doi:10.1016/j.resuscitation.2009.12.008

Abstract

Background Most reports of Rapid Response Systems (RRS) focus on the efferent, response component of the system, although evidence suggests that improved vital sign monitoring and recognition of a clinical crisis may have outcome benefits. There is no consensus regarding how best to detect patient deterioration or a clear description of what constitutes patient monitoring. Methods A consensus conference of international experts in safety, RRS, healthcare technology, education, and risk prediction was convened to review current knowledge and opinion on clinical monitoring. Using established consensus procedures, four topic areas were addressed: (1) To what extent do physiologic abnormalities predict risk for patient deterioration? (2) Do workload changes and their potential stresses on the healthcare environment increase patient risk in a predictable manner? (3) What are the characteristics of an "ideal" monitoring system, and to what extent does currently available technology meet this need? and (4) How can monitoring be categorized to facilitate comparing systems? Results and conclusions The major findings include: (1) vital sign aberrations predict risk, (2) monitoring patients more effectively may improve outcome, although some risk is random, (3) the workload implications of monitoring on the clinical workforce have not been explored, but are amenable to study and should be investigated, (4) the characteristics of an ideal monitoring system are identifiable, and it is possible to categorize monitoring modalities. It may also be possible to describe monitoring levels, and a system is proposed.

Item Details

Item Type:Refereed Article
Keywords:Rapid response system; Monitoring; Vital signs; Medical emergency team; Rapid response team; Critical care outreach; Cardiac arrest; Resuscitation; Patient safety; Risk
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Buist, MD (Professor Michael Buist)
ID Code:68233
Year Published:2010
Web of Science® Times Cited:226
Deposited By:Rural Clinical School
Deposited On:2011-03-10
Last Modified:2011-06-10
Downloads:9 View Download Statistics

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