title: Incorporating Patient Acuity Rating Score Into Patient Handoffs and the Correlation With Rapid Responses and Unexpected ICU Transfers.
abstract: Handoffs and rapid response team (RRT) activations have been a focus for quality improvement in hospital medicine. This study aimed to incorporate a previously used scoring system (1-7) for severity of illness on initial encounter as a handoff adjunct and to determine its impact on the number of RRTs and intensive care unit transfers. The Patient Acuity Rating (PAR) scale correlates with subsequent RRTs and transfers to a higher level of care, with higher scores leading to increased rates of RRTs and transfers. Patients who experienced an RRT at any time (mean score 4.69), within 24 hours (4.74), or an unplanned transfer (5.16) had higher PAR scores on assessment than those who did not (4.02; all P < .05). There was an increased likelihood of RRTs and transfers with scores of 6 or higher. There was no reduction in the quantity of RRTs or unplanned intensive care unit transfers comparing preintervention and postintervention data.
authors.affiliation: 1 Emory University, Atlanta, GA.|2 Duke University Health System, Durham, NC.
authors.forename: Christopher
authors.initials: C
authors.lastname: O'Donnell
authors.affiliation: 2 Duke University Health System, Durham, NC.
authors.forename: Samantha
authors.initials: S
authors.lastname: Thomas
authors.affiliation: 2 Duke University Health System, Durham, NC.
authors.forename: Crystal
authors.initials: C
authors.lastname: Johnson
authors.affiliation: 2 Duke University Health System, Durham, NC.
authors.forename: Lalit
authors.initials: L
authors.lastname: Verma
authors.affiliation: 2 Duke University Health System, Durham, NC.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bae
authors.affiliation: 2 Duke University Health System, Durham, NC.
authors.forename: David
authors.initials: D
authors.lastname: Gallagher
mesh_terms: D057209:Hospital Rapid Response Team / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units; D062072:Patient Acuity; D062209:Patient Handoff / Q000458:organization & administration; D010360:Patient Transfer / Q000379:methods*; D058996:Quality Improvement; D012720:Severity of Illness Index
keywords: PAR score; handoffs; hospitalists; rapid responses