Implementation of Remote Patient Monitoring and Earlier CERT Activation: Effects on ICU Transfer and Mortality

Area of Science:

• Critical Care Medicine
• Health Informatics
• Patient Safety

Background:

• Timely detection of clinical deterioration is crucial but challenging due to intermittent vital signs monitoring.
• Remote patient monitoring (RPM) offers high-frequency surveillance to potentially enable earlier recognition of patient decline.
• Integrating RPM into rapid response workflows may improve outcomes for patients requiring clinical emergency response team (CERT) activation and intensive care unit (ICU) transfer.

Purpose of the Study:

• To evaluate if RPM integration into rapid response workflows improves clinical outcomes in adult patients.
• To assess the impact of RPM on severity of illness and mortality following CERT activation and ICU transfer.
• To compare outcomes between patients monitored with RPM and those without.

Main Methods:

• A retrospective study comparing patients before and after RPM implementation.
• Inclusion criteria: adult patients experiencing CERT activation followed by ICU transfer.
• Primary outcomes: severity of illness at ICU admission (APACHE-IV) and in-hospital mortality.

Main Results:

• The post-RPM group (n=464) showed a lower mean APACHE-IV score (83.96 vs. 90.01; p=0.0016) compared to the pre-RPM group (n=656).
• In-hospital mortality was reduced in the post-RPM group (7.75% vs. 11.48%; p=0.084).
• Total length of stay (LOS) was significantly shorter in the post-RPM group (10.50 vs. 11.95 days; p=0.0278).

Conclusions:

• RPM integration into hospital care pathways facilitated earlier recognition of clinical deterioration.
• RPM use was associated with reduced illness severity at ICU admission and lower in-hospital mortality.
• RPM shows utility in comprehensive rapid response models to enhance patient safety and outcomes in acute care.