Can Early Warning Systems Enhance Detection of High Risk Patients by Rapid Response Teams?

2021 ◽  
pp. 088506662097814
Author(s):  
Peter M. Reardon ◽  
Andrew J. E. Seely ◽  
Shannon M. Fernando ◽  
Simon Didcote ◽  
Iain Strachan ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Early Warning ◽  
Tertiary Care ◽  
Warning System ◽  
Rapid Response Team ◽  
Early Warning Systems ◽  
Rapid Response ◽  
Warning Systems ◽  
Prognostic Accuracy ◽  
Response Team

Purpose: We sought to evaluate if incorporating an early warning system (EWS), the Visensia Safety Index (VSI) and the National Early Warning Systems 2 (NEWS2), may lead to earlier identification of rapid response team (RRT) patients. Methods: This was a retrospective study (2015-2018) of patients experiencing RRT activation within a tertiary care network. We evaluated the proportion of patients with an EWS alert prior to RRT activation and their associated outcomes (primary: hospital mortality). Results: There were 6,346 RRT activations over the study period. Of these, 2042 (50.8%) patients would have had a VSI alert prior to RRT activation, with a median advanced time of 3.6 (IQR 0.5-12.8) hours, compared to 2351 (58.4%) patients and 9.8 (IQR 2.0-18.7) hours for NEWS2. Patients with a potential alert prior to RRT activation had an increased odds of mortality for both VSI (OR 1.2, 95%CI 1.1-1.3) and NEWS2 (OR 2.7, 95% CI 2.4-3.1). Prognostic accuracy for hospital mortality was similar between groups. Conclusion: Utilization of an EWS by an RRT has potential to provide earlier recognition of deterioration and mortality risk among hospitalized inpatients.

scholarly journals Effect of modified early warning system on rapid response team call outcome

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Shahriar Dadkhah ◽  
Ekta Shrestha ◽  
Aswin Ratna Kansakar ◽  
Negar Faramarzi ◽  
Amishi Parekh ◽  
...  
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Response Team

scholarly journals Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259577
Author(s):  
Lorena Micheline Alves Silva ◽  
Diego Marques Moroço ◽  
José Paulo Pintya ◽  
Carlos Henrique Miranda
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Early Warning ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Early Warning Score ◽  
Before And After ◽  
Response Team

Background Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the modified early warning score (MEWS) in high-risk wards offering ED support is associated with decreased in-hospital mortality rate. Methods A before-and-after cross-sectional study compared in-hospital mortality rates before and after implementation of an RRT triggered by the MEWS ≥4 in two wards of a tertiary hospital that offer ED support. Results We included 6863 patients hospitalized in these wards before RRT implementation from July 2015 through June 2017 and 6944 patients hospitalized in these same wards after RRT implementation from July 2018 through June 2020. We observed a statistically significant decrease in the in-hospital mortality rate after intervention, 449 deaths/6944 hospitalizations [6.47% (95% confidence interval (CI) 5.91%– 7.07%)] compared to 534 deaths/6863 hospitalizations [7.78% (95% CI 7.17–8.44)] before intervention; with an absolute risk reduction of -1.31% (95% CI -2.20 –-0.50). Conclusion RRT trigged by the MEWS≥4 in high-risk wards that offer ED support was found to be associated with a decreased in-hospital mortality rate. A further cluster-randomized trial should evaluate the impact of this intervention in this setting.

scholarly journals Brief communication "Landslide Early Warning System: toolbox and general concepts"

2013 ◽  
Vol 13 (1) ◽  
pp. 85-90 ◽  
Author(s):  
E. Intrieri ◽  
G. Gigli ◽  
N. Casagli ◽  
F. Nadim
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Warning System ◽  
Early Warning Systems ◽  
End Users ◽  
Flow Chart ◽  
Warning Systems ◽  
Limited Experience ◽  
Practical Guidelines ◽  
Landslide Early Warning

Abstract. We define landslide Early Warning Systems and present practical guidelines to assist end-users with limited experience in the design of landslide Early Warning Systems (EWSs). In particular, two flow chart-based tools coming from the results of the SafeLand project (7th Framework Program) have been created to make them as simple and general as possible and in compliance with a variety of landslide types and settings at single slope scale. We point out that it is not possible to cover all the real landslide early warning situations that might occur, therefore it will be necessary for end-users to adapt the procedure to local peculiarities of the locations where the landslide EWS will be operated.

scholarly journals Communication architecture of an early warning system

2010 ◽  
Vol 10 (11) ◽  
pp. 2215-2228 ◽  
Author(s):  
M. Angermann ◽  
M. Guenther ◽  
K. Wendlandt
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Satellite Communication ◽  
Warning System ◽  
Early Warning Systems ◽  
Lessons Learned ◽  
Warning Systems ◽  
Communication Architecture ◽  
Design And Implementation ◽  
Communication Links

Abstract. This article discusses aspects of communication architecture for early warning systems (EWS) in general and gives details of the specific communication architecture of an early warning system against tsunamis. While its sensors are the "eyes and ears" of a warning system and enable the system to sense physical effects, its communication links and terminals are its "nerves and mouth" which transport measurements and estimates within the system and eventually warnings towards the affected population. Designing the communication architecture of an EWS against tsunamis is particularly challenging. Its sensors are typically very heterogeneous and spread several thousand kilometers apart. They are often located in remote areas and belong to different organizations. Similarly, the geographic spread of the potentially affected population is wide. Moreover, a failure to deliver a warning has fatal consequences. Yet, the communication infrastructure is likely to be affected by the disaster itself. Based on an analysis of the criticality, vulnerability and availability of communication means, we describe the design and implementation of a communication system that employs both terrestrial and satellite communication links. We believe that many of the issues we encountered during our work in the GITEWS project (German Indonesian Tsunami Early Warning System, Rudloff et al., 2009) on the design and implementation communication architecture are also relevant for other types of warning systems. With this article, we intend to share our insights and lessons learned.

A novel configuration of a traditional rapid response team decreases non-intensive care unit arrests and overall hospital mortality

2015 ◽  
Vol 10 (6) ◽  
pp. 352-357 ◽  
Author(s):  
Daniel P. Davis ◽  
Steve A. Aguilar ◽  
Patricia G. Graham ◽  
Brenna Lawrence ◽  
Rebecca E. Sell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Response Team

Toward a typology of weak-signal early alert systems: functional early warning systems in the post-COVID age

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jan Černý ◽  
Martin Potančok ◽  
Elias Castro Hernandez
Keyword(s):  
Peer Review ◽  
Early Warning ◽  
Warning System ◽  
Early Warning Systems ◽  
Weak Signal ◽  
Warning Systems ◽  
Weak Signals ◽  
Content Type ◽  
Human In The Loop ◽  
Early Alert Systems

PurposeThe study aims to expand on the concept of an early warning system (EWS) by introducing weak-signal detection, human-in-the-loop (HIL) verification and response tuning as integral parts of an EWS's design.Design/methodology/approachThe authors bibliographically highlight the evolution of EWS over the last 30+ years, discuss instances of EWSs in various types of organizations and industries and highlight limitations of current systems.FindingsProposed system to be used in the transforming of weak signals to early warnings and associated weak/strong responses.Originality/valueThe authors contribute to existing literature by presenting (1) novel approaches to dealing with some of the well-known issues associated with contemporary EWS and (2) an event-agnostic heuristic for dealing with weak signals.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-11-2020-0513.

Abstract 288: Rapid Response Team Implementation Associated with Reductions in In-hospital Mortality Rate and Hospitalization Costs: A Retrospective Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Jacob Sessim Filho ◽  
Renato P Azevedo ◽  
Antonildes N Assuncao ◽  
Marcia M Sa ◽  
Felipe D Silva ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Statistical Power ◽  
Early Recognition ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Clinical Deterioration ◽  
Medical Database ◽  
Hospitalization Costs ◽  
Response Team

Introduction: Early recognition of clinical deterioration in inpatient subjects seems to be one of the main factors associated with prevention of in-hospital severe adverse events occurrence. Previous studies failed to demonstrate that the implementation of a rapid response team (RRT) could reduce in-hospital mortality rate. Hypothesis: Could a RRT implementation reduces in-hospital mortality and/or hospitalizations costs in a private general hospital in Brazil? Methods: This is a retrospective cohort built from data of electronic medical database of consecutive adult inpatients admitted to general wards who had to be transferred to an ICU after an acute clinical deterioration between May 1st, 2012 and June 30th, 2016. Subjects were divided into two groups as follows: group 1 (G1) with those admitted to ICU before RRT implementation on June 1st, 2014 and group 2 (G2) with the ones admitted to ICU after the implementation. All patients in G2 received care by the RRT before ICU admittance. In cases in which a patient had more than one hospital admission, only the first admittance was used for analyses. Results: Patients data are shown in table 1.Outcome data are shown in table 2. Conclusions: From these data, it is possible to infer that this RRT implementation at this hospital was associated with improvement in clinical outcomes of inpatients who needed an ICU admittance after an acute clinical deterioration, as well as a significant reduction of their hospitalization costs. These data reinforce the hypotheses that MERIT study was underpowered. Further multicenter randomized trials, with appropriate statistical power, shall be proposed to address these questions.

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