Background: General patient acuity is increasing in the United States, with more patients having multiple comorbidities and acute-on-chronic conditions. Hospitalizations may also be complicated by serious adverse events, often unrelated to the admitting medical diagnosis. In our facility, the late detection of patient deterioration on general medical units often resulted in increased length of stay (LOS) in the ICU and poor patient outcomes. Purpose: The purpose of this project was to improve patient surveillance and better identify early signs of patient deterioration through the use of continuous vital sign monitoring technology. Methods: To improve detection of patient deterioration, a nurse-led monitoring and response system was developed using a wearable, wireless device for continuous vital sign surveillance. The patient data the device provided was used with early warning scores and sepsis screening protocols for timely goal-directed interventions. Results: Ninety-seven percent of patient deterioration events were recognized and treated as a result of this continuous monitoring and response system. Rapid response team activations decreased by 53% between baseline and the intervention period. LOS among patients transferred to the ICU decreased from 2.82 to 2.19 days. Nurse satisfaction with use of the continuous monitoring device was positive, with 74% of nurses surveyed reporting that information provided by the device enhanced decision-making. Conclusions: New technology for patient surveillance, in this case a nurse-led monitoring and response system, can be successfully integrated into general care practice. Use of the nurse-led response system helped nurses recognize early signs of deterioration and continue meaningful patient interactions.

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Objective: We describe the practical aspects of planning for and executing the safe movement of patients and care teams from an existing tertiary hospital (Mafraq Hospital) to a new hospital (Sheikh Shakhbout Medical City) in Abu Dhabi, United Arab Emirates.Methods: Field notes and measures taken during the planning and execution of this event were prospectively collated by the authors to inform the final manuscript.Results: A central command structure similar to that used for major disaster management helped to guide the move of all inpatients, staff and support services from one hospital to the other. Five patient tracks (clinical teams) were established to move patients to the new facility concurrently along set and separate routes. Five additional support tracks were established to provide logistical support for the movement of essential non-patient resources. A total of 142 acutely ill general care and critically ill hospital patients were moved during a five-hour period with zero patient harm events.Conclusions: The tools, processes used, and lessons learned in this exercise are shared in the hope that others who are required to move hospitals can learn from and use our experience.