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The use of altered rapid response calling criteria in a tertiary referral facility

Crouch, S., Trahair, L. G. and Aitken, L. M. ORCID: 0000-0001-5722-9090 (2020). The use of altered rapid response calling criteria in a tertiary referral facility. Australian Critical Care, doi: 10.1016/j.aucc.2020.07.011

Abstract

Purpose
The purpose of this study was to examine the current utilisation of altered rapid response calling criteria (ARRCCs) at a tertiary hospital.

Methods
A retrospective review of all acute care admissions across 17 months was undertaken using the hospital administration system and electronic medical record to identify patients with ARRCCs. In patients with altered criteria, the type of alteration, frequency of rapid response calls, cardiac arrest, intensive care admission, and death in the hospital were identified. Comparisons were made using standard statistical methods.

Results
The total hospital admissions numbered 45 912, with ARRCCs used in 768 (1.7%). Patients with an ARRCC during hospital admission were older (68.5 [55.5, 79.0] vs 59.0 [43.0, 72.0] years, p < 0.001) and had a significantly longer length of hospital stay (6.9 [3.0, 16.3] vs 2 [1, 5] days, p < 0.001).Compared with the total group of patient admissions, patients with ARRCCs more frequently triggered a rapid response team (9.0% vs 14.2%, χ 2(1, n = 46 680) = 23.87, p < 0.001), more frequently suffered a cardiac arrest (0.2 vs 0.9%, χ 2(1, n = 46 678) = 20.34, p < 0.001), more frequently died in the hospital (p < 0.001), and were less frequently discharged home (χ 2(1, n = 46 680) = 43.91, p < 0.001).

Conclusion
Patients with an ARRCC stayed longer in the hospital and were at increased risk of cardiac arrest and death during hospitalisation. Further exploration of the role of ARRCCs in facilitating individualised care to meet the needs and treatment goals of each patient in the acute hospital setting is required.

Publication Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: Rapid response systems, Early warning score, Clinical deterioration, Medical emergency team
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health Sciences
Date Deposited: 15 Oct 2020 10:52
URI: https://openaccess.city.ac.uk/id/eprint/25099
[img] Text - Accepted Version
This document is not freely accessible until 14 October 2021 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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