Value of improving patient safety: health economic considerations for rapid response systems–a rapid review of the literature and expert round table

Abstract

ObjectivesFailure to rescue deteriorating patients in hospital is a well-researched topic. We aimed to explore the impact of safer care on health economic considerations for clinicians, providers and policymakers.DesignWe undertook a rapid review of the available literature and convened a round table of international specialists in the field including experts on health economics and value-based healthcare to better understand health economics of clinical deterioration and impact of systems to reduce failure to rescue.ResultsOnly a limited number of publications have examined the health economic impact of failure to rescue. Literature examining this topic lacked detail and we identified no publications on long-term cost outside the hospital following a deterioration event. The recent pandemic has added limited literature on prevention of deterioration in the patients’ home.Cost-effectiveness and cost-efficiency are dependent on broader system effects of adverse events. We suggest including the care needs beyond the hospital and loss of income of patients and/or their informal carers as well as sickness of healthcare staff exposed to serious adverse events in the analysis of adverse events. They are likely to have a larger health economic impact than the direct attributable cost of the hospital admission of the patient suffering the adverse event. Premorbid status of a patient is a major confounder for health economic considerations.ConclusionIn order to optimise health at the population level, we must limit long-term effects of adverse events through improvement of our ability to rapidly recognise and respond to acute illness and worsening chronic illness both in the home and the hospital.

Digital Remote Monitoring Using an mHealth Solution for Survivors of Cancer: Protocol for a Pilot Observational Study

“…Along with these observational outcomes, patient safety remains paramount in our pilot and in all future interventions [ 59 , 60 ]. Therefore, besides the patient-prompted 24/7 acute oncology helpline, we have also put in place a safety net by which the clinical research team will have access to the web-based dashboard summarizing all the ESAS scores and the smartwatch objective data, with the possibility of escalation to the leading oncologist in case of severe symptoms or profoundly abnormal vital data.…”