The goal is to develop a two-tiered monitoring system to improve the care of patients at risk for clinical deterioration on general hospital wards (GHWs) at Barnes-Jewish Hospital (BJH). The investigators hypothesize that the use of an automated early warning system (EWS) that identifies patients at risk of clinical deterioration, with notification of nurses on the GHWs when patients are identified, will reduce the risk of ICU transfer or death within 24 hrs of an alert. As a substudy, the investigators will pilot the use of a wireless pulse oximeter to establish feasibility and to develop algorithms for a real-time event detection system (RDS) in these high-risk patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
20,031
An automated algorithm (EWS) will identify patients at potential risk of clinical deterioration. When a patient satisfies the algorithm, a nurse on the patient's ward will be notified. S/he will assess the patient and institute any interventions that are clinically required.
A subset of patients will be consented to wear a wireless sensor device which will monitor heart rate and level of oxygen in the blood.
Barnes Jewish Hospital
St Louis, Missouri, United States
Transfer to ICU or Unexpected Death Within 24 Hrs of Identification by the EWS Algorithm
The proportion of patients transferred to ICU or death within 24 hrs of identification by the EWS algorithm for intervention and control wards.
Time frame: Within 24 hrs of an EWS alert
Clinical Outcomes and Process Measures
length of stay
Time frame: Hospital discharge
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.