title: Mortality and Length of Stay Trends Following Implementation of a Rapid Response System and Real-Time Automated Clinical Deterioration Alerts.
abstract: A study was performed to determine the potential influence of a rapid response system (RRS) employing real-time clinical deterioration alerts (RTCDAs) on patient outcomes involving 8 general medicine units. Introduction of the RRS occurred in 2006 with staged addition of the RTCDAs in 2009. Statistically significant year-to-year decreases in mortality were observed through 2014 ( r = -.794; P = .002). Similarly, year-to-year decreases in the number of cardiopulmonary arrests (CPAs; r = -.792; P = .006) and median lengths of stay ( r = -.841; P = .001) were observed. There was a statistically significant year-to-year increase in the number of RRS activations for these units ( r = .939; P < .001) that was inversely correlated with the occurrence of CPAs ( r = -.784; P = .007). In this single-institution retrospective study, introduction of a RRS employing RTCDAs was associated with lower hospital mortality, CPAs, and hospital length of stay.
authors.affiliation: 1 Washington University, St Louis, MO.
authors.forename: Marin H
authors.initials: MH
authors.lastname: Kollef
authors.affiliation: 2 BJC HealthCare, St Louis, MO.
authors.forename: Kevin
authors.initials: K
authors.lastname: Heard
authors.affiliation: 1 Washington University, St Louis, MO.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 1 Washington University, St Louis, MO.
authors.forename: Chenyang
authors.initials: C
authors.lastname: Lu
authors.affiliation: 3 Barnes-Jewish Hospital, St Louis, MO.
authors.forename: Nelda
authors.initials: N
authors.lastname: Martin
authors.affiliation: 1 Washington University, St Louis, MO.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bailey
mesh_terms: D000328:Adult; D000368:Aged; D000075902:Clinical Deterioration; D005260:Female; D006323:Heart Arrest / Q000401:mortality; D017052:Hospital Mortality / Q000639:trends*; D057209:Hospital Rapid Response Team / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies
keywords: clinical deterioration alert; hospital length of stay; morbidity and mortality; rapid response system