Abstract
Overnight medical cover in hospital is less than during daylight hours. We aimed to quantify the numbers of patients deteriorating overnight and their clinical outcome. Data was collected in real time on use of the Standardised Early Warning Score (SEWS), ‘time to doctor’, seniority of medical review and clinical outcome.
136 incidents of clinical concern were noted on the general wards with a median response time of 5 minutes for SEWS>4 and 10 minutes if SEWS<4. 159 incidents were recorded in critical care. There was significant inter-speciality variation in median response times and seniority of responding staff, particularly within critical care, which recorded the slowest times across the hospital.
This will be reassessed following the establishment of Hospital at Night.
[download-attachments container="div" style="list" dipslay_icon="1" display_count="1" display__size="0"]
References
- Bell CM and Redelmeier DA. Mortality among patients admitted to hospital on weekends as compared with weekdays. NEJM 2001; 345(9): 663–8.
- Barba R, Losa JE, Velasco M et al. Mortality among adult patients admitted to the hospital on weekends. Eur J Intern Med 2005; 17(5): 322–4.
- www.drfosterintelligence.co.uk/newsPublications/article.asp?articleid= 6&from.
- Schmulewitz L, Proudfoot A, Bell D. The impact of weekends on outcome for emergency patients. Clin Med 2005; 5(6): 621–5.
- Jarman B, Gault S, Alves B et al. Explaining differences in English hospital death rates using routinely collected data. BMJ 1999; 318(7197): 1515–20.
- http://www.rcplondon.ac.uk/news/statements/doc_OutofHours01.asp.
- Silbergleit R, Kronick SL, Philpott S et al. Quality of emergency care on the night shift. Acad Emerg Med 2006; 13(3): 325–30.
- Paterson R, MacLeod DC, Thetford D et al. Prediction of in-hospital mortality and length of stay using an early warning scoring system: clinical audit. Clin Med 2006; 6(3): 281–4.
Request Permissions
To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:
