Abstract
Aim
To determine the impact implementation of Emergency Department Clinical Emergency
Response System (EDCERS) on inpatient deterioration events and identify contributing
causal factors.
Methods
EDCERS was implemented in an Australian regional hospital, integrating a single parameter
track and trigger criteria for escalation of care, and emergency, specialty and critical
care clinician response to patient deterioration. In this controlled pre-post study,
electronic medical records of patients who experienced a deterioration event (rapid
response call, cardiac arrest or unplanned intensive care admission) on the ward within
72 h of admission from the emergency department (ED) were reviewed. Causal factors
contributing to the deteriorating event were assessed using a validated human factors
framework.
Results
Implementation of EDCERS reduced the number of inpatient deterioration events within
72 h of emergency admission with failure or delayed response to ED patient deterioration
as a causal factor. There was no change in the overall rate of inpatient deterioration
events.
Conclusion
This study supports wider implementation of rapid response systems in the ED to improve
management of deteriorating patients. Tailored implementation strategies should be
used to achieve successful and sustainable uptake of ED rapid response systems and
improve outcomes in deteriorating patients.
Keywords
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Article info
Publication history
Published online: May 18, 2023
Accepted:
May 3,
2023
Received in revised form:
May 3,
2023
Received:
February 1,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
Crown Copyright © 2023 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia. All rights reserved.
