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Use of automated systems to aid identification of patient deterioration in routine hospital practice is limited and their impact on patient outcomes remains unclear. This study was designed to evaluate the feasibility of implementing an electronic observation chart with automated early warning score (EWS) calculation in the high-acuity area of an emergency department.This study enrolled 3219 participants before and 3352 after implementation of an automated system, using bedside vital-sign entry on networked mobile devices. The primary outcome measure was the percentage of participants for whom an EWS was accurately recorded at each stage.Of the participants, 52.7% before and 92.9% after implementation of the electronic system had an accurate EWS recorded on charts available to the study team. Participant groups were well balanced for baseline characteristics and acuity.In this study, the feasibility and limitations of implementing an electronic observation chart in the ED were demonstrated. Accurate EWS documentation was more frequent after implementation of the electronic observation chart. Retrospective analysis suggests that the use of an electronic observation system may lead to a greater percentage of observations being taken from those patients with a higher EWS.

Original publication

DOI

10.1097/mej.0000000000000371

Type

Journal article

Journal

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

Publication Date

12/2017

Volume

24

Pages

e11 - e16

Addresses

aEmergency Department, John Radcliffe Hospital bDepartment of Engineering Science, Institute of Biomedical Engineering cCentre for Statistics in Medicine, Botnar Research Centre, Oxford University, Oxford dEmergency Department, Wexham Park Hospital, Slough, UK.

Keywords

Humans, Critical Illness, Disease Progression, Monitoring, Physiologic, Medical Records Systems, Computerized, Statistics, Nonparametric, Retrospective Studies, Feasibility Studies, Adult, Aged, Middle Aged, Emergency Service, Hospital, Emergency Medical Services, Female, Male, Quality Improvement, United Kingdom