Understanding the "alarm problem" associated with continuous physiologic monitoring of general care patients.

Study Aim: The aim of this study is to investigate the impact of alarm configuration tactics in general care settings.

Methods: Retrospective analysis of over 150,000 hours of medical/surgical unit continuous SpO2 and pulse rate data were used to estimate alarm rates and impact on individual nurses.

Results: Application of an SpO2 threshold of 80% vs 88% produced an 88% reduction in alarms.

A Pragmatic Method for Measuring Inpatient Complications and Complication-Specific Mortality.

Objectives: The primary objective of this study was to develop hospital-level metrics of major complications associated with mortality that allows for the identification of opportunities for improvement. The secondary objective is to improve upon current metrics for failure to rescue (i.e.

Improvement of sepsis identification through multi-year comparison of sepsis and early warning scores.

Background: Sepsis remains a leading cause of death among inpatients. Scoring systems designed to identify inpatients with sepsis currently have limited effectiveness. This single institution, retrospective, case-control study aims to improve sepsis decision support tool performance using temporal analyses of sepsis-specific and general deterioration scoring systems.

Characterizing rescue performance in a tertiary care medical center: a systems approach to provide management decision support.

Background: Allocation of limited resources to improve quality, patient safety, and outcomes is a decision-making challenge health care leaders face every day. While much valuable health care management research has concentrated on administrative data analysis, this approach often falls short of providing actionable information essential for effective management of specific system implementations and complex systems. This comprehensive performance analysis of a hospital-wide system illustrates application of various analysis approaches to support understanding specific system behaviors and identify leverage points for improvement.

Patterns in continuous pulse oximetry data prior to pulseless electrical activity arrest in the general care setting.

The study objective was to understand if features derived from continuous pulse oximetry data can provide advanced warning of pulseless electrical activity arrest in the general care inpatient setting. Retrospective analysis of SpO2 and pulse rate data derived from continuous pulse oximetry was performed for pulseless electrical activity (n = 38) and control (n = 42) patient cohorts. Measures of central tendency and variation over time intervals ranging from 1 min to 1 h were used for inter- and intra-group comparisons.