Incorporating Patient Acuity Rating Score Into Patient Handoffs and the Correlation With Rapid Responses and...

Area of Science:

• Hospital Medicine
• Quality Improvement
• Patient Safety

Background:

• Handoffs and rapid response team (RRT) activations are critical areas for quality improvement in hospital medicine.
• Effective patient handoffs are essential for preventing adverse events and ensuring continuity of care.
• Previous methods for assessing patient acuity during handoffs have limitations.

Purpose of the Study:

• To evaluate the impact of incorporating the Patient Acuity Rating (PAR) scale as a handoff adjunct.
• To determine if the PAR scale influences the number of RRT activations and intensive care unit transfers.
• To assess the correlation between the PAR scale scores and subsequent critical care events.

Main Methods:

• A scoring system (1-7) for severity of illness on initial encounter, the PAR scale, was used as a handoff adjunct.
• Data on RRT activations and intensive care unit transfers were collected and analyzed.
• Patient PAR scores were compared between those who experienced RRTs/transfers and those who did not.

Main Results:

• The PAR scale demonstrated a correlation with subsequent RRTs and transfers to a higher level of care.
• Patients experiencing an RRT (mean score 4.69) or unplanned transfer (5.16) had significantly higher PAR scores than those who did not (4.02; P < .05).
• Higher PAR scores (≥6) were associated with an increased likelihood of RRTs and transfers, though no overall reduction in event quantity was observed post-intervention.

Conclusions:

• The PAR scale is a valuable adjunct for assessing patient acuity during handoffs.
• The PAR scale can help identify patients at higher risk for RRT activation and intensive care unit transfer.
• Further research may be needed to optimize the use of the PAR scale for reducing critical care events.