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Published on: January 15, 2017
Emergency department abnormal vital sign "triggers" program improves time to therapy
Daniel C McGillicuddy1, Francis J O'Connell, Nathan I Shapiro
1Beth Israel Deaconess Medical Center (FJO, SAC, JCR), Boston, MA, USA. dmcgilli@bidmc.harvard.edu
Summary
Implementing an emergency department (ED) trigger system significantly reduced time to physician evaluation and therapeutic interventions for deteriorating patients. This rapid response method improves patient care by quickly identifying and treating critical conditions.
Area of Science:
- Emergency Medicine
- Critical Care
- Patient Safety
Background:
- Rapid response systems improve patient outcomes by identifying deteriorating patients.
- Vital sign abnormality trigger systems are an effective rapid response method.
Purpose of the Study:
- Evaluate a triage-based trigger system's effect on time to physician evaluation in emergency department (ED) patients.
- Assess secondary outcomes including therapeutic intervention, antibiotics, and disposition.
Main Methods:
- Retrospective pre- and postintervention study of ED patients using chart review.
- Trigger criteria included abnormal heart rate, respiratory rate, blood pressure, and oxygen saturation.
- Statistical analysis compared median times using the Wilcoxon rank sum test.
Main Results:
- Median time to physician evaluation decreased significantly from 21 to 11 minutes.
- Median time to first intervention and antibiotics also showed significant reductions.
- Time to disposition was not significantly affected by the trigger system.
Conclusions:
- An ED trigger program enables faster physician evaluation and therapeutic interventions.
- This system is effective in improving the timeliness of care for critical patients.
- The findings support the implementation of trigger systems in emergency departments.
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