Research Article
Impact of a Local Low-Cost Ward-Based Response System in a Canadian Tertiary Care Hospital
Table 1
Baseline characteristics, call records, and outcomes.
| (a) |
| | 82 | | Male (%) | 47 (57) | | Age (years), mean (SD) | 70.4 (15.6) | | Admission diagnosis by category | | | (i) Respiratory (%) | 27 (33) | | (ii) Malignancy (%) | 16 (21) | | (iii) Infectious disease (%) | 10 (12) | | (iv) Cardiac (%) | 10 (12) | | (v) Gastrointestinal (%) | 8 (9) | | (vi) Other (%) | 11 (13) |
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| (b) |
| | Total calls (mean per week) | 95 (1.8) | | (i) Daytime calls (8:00 h–18:00 h) (%) | 38 (40) |
| | Activation triggers, call characteristics | | | (i) Blood pressure (%) | 17 (18) | | (ii) Heart rate (%) | 7 (7) | | (iii) Respiratory rate (%) | 17 (18) | | (iv) Change in mental status (%) | 20 (21) | | (v) Serious concern (%) | 23 (24) | | (vi) Multiple or unknown (%) | 11 (12) |
| | Initial intervention after system activation | | | (i) Critical care consultation (%) | 32 (44) | | (ii) Initiation of pharmacotherapy oxygen therapy (%) | 40 (42) | | (iii) STAT imaging (%) | 4 (4) | | (iv) Clinical procedures (intubation, central line, and ABG) (%) | 11 (12) | | (v) Information not available | 8 (8) |
| | Patients with poor prognostic factors () | 52 | | (i) Advanced dementia or long-term care facility (% total) | 8 (9) | | (ii) Advanced cardiac or respiratory disease (% total) | 22 (27) | | (iii) Active malignancy (% total) | 22 (27) |
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| (c) |
| | | Before intervention | After intervention | value |
| | Time from decompensation to intervention (min) (IQR) | 204 (1–10) | 5 (0.6–12.4) | <0.001 | | ICU admissions (per 1000 patient days) | 4.8 | 3.3 | 0.04 | | APACE II scores (mean) (CI 95%) | 28.4 (26.3–30.5) | 25.2 (23.0–27.5) | 0.04 | | CTU code blue rates (per 1000 patient days) | 2.2 | 1.2 | 0.02 | | Hospital-wide code blue rates (per 1000 patient days) | 1.2 | 1.1 | 0.56 | | CTU mortality (%) | 10.1 | 10.9 | 0.64 | | 30-day ICU mortality (%) | 29.3 | 34.5 | 0.53 |
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