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Delayed Emergency Team Calls and Associated Hospital Mortality: A Multicenter Study
Jack Chen1, Rinaldo Bellomo, Arthas Flabouris
11Simpson Centre for Health Services Research, Ingham Institute of Applied Medical Research & South Western Clinical School, University of New South Wales, Sydney, NSW, Australia. 2Australian and New Zealand Intensive Care Research Centre, Monash University School and Public Health and Preventive Medicine, Melbourne, VIC, Australia. 3Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia. 4Discipline of Acute Care Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.
Delayed emergency response in hospitals increases patient mortality risk. Prompt intervention for deteriorating ward patients is crucial to reduce unplanned ICU admissions and deaths.
Area of Science:
- Critical Care Medicine
- Hospital Quality Improvement
- Patient Safety
Background:
- Delayed responses to patient deterioration in hospital wards are a significant concern.
- Effective emergency response systems are vital for improving patient outcomes.
Purpose of the Study:
- To test the hypothesis that delayed emergency responses (over 15 minutes) in hospital ward patients are associated with increased mortality.
- To evaluate the impact of rapid response teams on the timeliness of emergency calls.
Main Methods:
- A cluster randomized trial involving 23 hospitals comparing rapid response teams to standard care.
- Analysis of emergency calls, including periods before, during, and after rapid response system implementation.
- Statistical association between delayed calls and patient mortality, unplanned ICU admissions, and cardiac arrests.
Main Results:
- Overall, nearly one-third of emergency calls were delayed.
- Rapid response teams significantly decreased the proportion of delayed calls in intervention hospitals.
- Delayed calls were independently associated with increased risk of unplanned ICU admissions (aOR=1.56) and death (aOR=1.79).
Conclusions:
- Emergency team activation delayed by over 15 minutes after detecting patient instability is independently linked to higher ICU admission and mortality risks.
- Implementing rapid response systems can help mitigate delays in emergency response.
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