Antecedents to hospital deaths

Hillman, Ken; Bristow, P.; Chey, Tien; Daffurn, Katharine; Jacques, Theresa; Norman, Sandra L.; Bishop, Gillian; Simmons, Grant

doi:10.1046/j.1445-5994.2001.00077.x

Cited by 368 publications

(188 citation statements)

References 30 publications

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“…However, the clinical criteria which have been used in previous reports for the calling of a MET have been based on clinical experience and/or retrospective data [5][6][7][8][9]13]. Since the introduction of a MET requires additional resources, the development of accurate clinical criteria is required to avoid unnecessary calling of the MET.…”

Section: Discussionmentioning

confidence: 99%

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Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study

et al. 2004

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have suggested that 66-84% of inhospital cardiac arrests are preceded by at least one abnormal clinical observation [5][6][7][8]. Traditionally, these observations are reported by nursing staff to junior medical staff, leading to delays in evaluation and definitive care.…”

Section: Introductionmentioning

confidence: 99%

Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study

et al. 2004

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“…[8][9][10]19 Our reviewers tried to determine whether earlier or different interventions might have prevented the deterioration and the resulting unplanned transfer. Interestingly, in the large majority (94/ 106, 89%) they concluded that nothing different could have been done and that the transfer could not have been avoided.…”

Section: Discussionmentioning

confidence: 99%

Unplanned transfers to a medical intensive care unit: Causes and relationship to preventable errors in care

Bapoje

Gaudiani

Narayanan

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Unplanned intensive care unit (ICU) transfers may result from errors in care but the frequency of their occurrence, and whether these transfers might be prevented, has not been investigated.OBJECTIVE:To determine why unplanned transfers occur, what fraction results from errors in care, whether they are preceded by changes in clinical status and if so, whether earlier or different responses might prevent the transfers.DESIGN:Retrospective study.SETTING:University‐affiliated hospital.PATIENTS:All patients 18 to 89 years with unplanned transfers to the medical ICU from June 1, 2005 to May 30, 2006.INTERVENTION:None.MEASUREMENTS:Demographics, admission and transfer diagnoses, clinical triggers preceding the transfer, mortality, judgment by three reviewers about cause of transfer and whether it could have been prevented.RESULTS:A total of 152 patients had unplanned transfers. The most common reasons were worsening of the problem for which the patient was admitted (48%) and development of a new problem (39%). Errors in care accounted for 29 transfers (19%), 15 of which were due to incorrect triage at the time of admission, and 14 due to iatrogenic errors. Of the 14 iatrogenic errors, the investigators determined that eight transfers might have been prevented by an earlier intervention. Agreement among the three reviewers was moderate to almost perfect (κ 0.55‐0.90).CONCLUSIONS:Although 19% of unplanned transfers to medical ICUs are associated with errors in care, almost 80% of these seem to be preventable. Most of the preventable errors resulted from inappropriate admission triage. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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“…Approximately 15% to 20% of inpatients develop significant adverse events, which are often preceded by a change in the patient's condition. 1,2 Many hospitals utilize medical emergency teams (METs) to deliver prompt care for deteriorating patients. METs have an emerging role in end-of-life care; up to 35% of patients who die in the hospital with a do not resuscitate (DNR) order have a MET activation during the admission.…”

Section: Resultsmentioning

confidence: 99%

Resource utilization and end‐of‐life care in a US hospital following medical emergency team‐implemented do not resuscitate orders

Dargin

Mackey

et al. 2014

Journal of Hospital Medicine

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BACKGROUND: Medical emergency teams frequently implement do not resuscitate orders, but little is known about end-of-life care in this population. OBJECTIVE:To examine resource utilization and end-of-life care following medical emergency team-implemented do not resuscitate orders. DESIGN: Retrospective review.SETTING: Single, tertiary care center. PATIENTS:Consecutive adult inpatients requiring a medical emergency team activation over 1 year. MEASUREMENTS:Changes to code status, time spent on medical emergency team activations, frequency of palliative care consultation, discharges with hospice care.

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Antecedents to hospital deaths

Abstract: There is a high incidence of serious vital sign abnormalities in the period before potentially preventable hospital deaths. These antecedents may identify patients who would benefit from earlier intervention.

Cited by 368 publications

References 30 publications

Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study

Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study

Unplanned transfers to a medical intensive care unit: Causes and relationship to preventable errors in care

Resource utilization and end‐of‐life care in a US hospital following medical emergency team‐implemented do not resuscitate orders

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