Application of Medical Information Systems for the detection of high risk patients: rapid care alerts. Pilot study of the ARA-Son Llàtzer Project.
OBJECTIVE
To describe the implementation of a Medical Information System (MIS) in the Critical Care Departament (CCD).


METHODS
A prospective observational cohort study was carried out.


METHODS
Clinical and Surgical wards in Son Llàtzer Hospital.


METHODS
Patients with criteria of rapid care alert (RCA) without treatment, cardiac arrest (CA), and unexpected ward deaths (UWD), during 2010.


METHODS
Age, sex, nursing shift, nursing alert, vital signs, unplanned admission to intensive care, CA, UWD and death.


RESULTS
The MIS detected 9647 episodes with RCA signs in 4020 patients (26.4 episodes/day). A total of 8547 episodes were reviewed. Sixty-five patients required rapid response by the intensive care staff; 61.5% were detected in the afternoon shift (15:00 a 22:00), and 61.5% were admitted to the CCD. Diminished consciousness (DC) and respiratory failure were the most frequent problems. The sepsis rate was 23%. We reviewed 45 CA and 35 UWD. Of the total cases of CA, 33 patients died (73.3%) and 66.7% had criteria of untreated RCA. Monitoring (P<.05) and rhythms amenable to defibrillation (P<.002) were associated to survival. As regards the UWD, 75% had criteria of untreated RCA, and 40.6% presented diminished consciousness. In the last 6 months there was a significant reduction in UWD (P=.01)


CONCLUSIONS
The MIS could be a complimentary tool in the activity of the CCD to improve the prognosis of hospitalized patients.
Servicio de Medicina Intensiva, Hospital Son Llàtzer, Palma de Mallorca, España. lsocias@hsll.es
L
L
Socías Crespí
G
G
Heras La Calle
V M
VM
Estrada Rodríguez
A
A
García Sánchez
P
P
Ibáñez-Lucía
D000368:Aged; D015331:Cohort Studies; D003422:Critical Care; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis*; D006751:Hospital Information Systems; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors