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Performance and Improvement of Track and Trigger Scores Before Rescue and Transfer in the General Care Setting
Susan P McGrath1,2, Irina M Perreard1, George T Blike1,3
1Division of Analytics Institute, Department of Surveillance Analytics Core, Dartmouth Hitchcock Medical Center, Lebanon.
Journal of Patient Safety
|September 23, 2025
Summary
Early warning scores effectively identify patient deterioration. Frequent calculation using continuous monitoring significantly improves detection times for critical events, aiding timely interventions.
Area of Science:
- Medical monitoring and patient safety
- Clinical informatics and healthcare systems
Background:
- Early warning scores (EWS) are crucial for detecting patient deterioration.
- Current EWS often rely on intermittent vital signs, potentially delaying recognition of critical events.
Purpose of the Study:
- To evaluate the performance of EWS using intermittent vital signs for general deterioration in medical/surgical settings.
- To explore the feasibility of near real-time EWS using continuous monitoring for inpatient assessment.
Main Methods:
- Retrospective comparative analysis of 4 EWS to identify patients needing rescue or transfer.
- Simulation to assess the impact of 5-minute EWS estimation versus intermittent vital signs.
Main Results:
- The National Early Warning Score (NEWS) demonstrated superior performance (AUC 0.82) in identifying patients requiring intervention.
- NEWS estimated every 5 minutes improved detection of critical events by over 5 hours on average.
Conclusions:
- EWS are effective in detecting general deterioration.
- Frequent EWS calculation with continuous monitoring data can enhance alarm systems, potentially reducing unwitnessed arrests and deaths.
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