Track and trigger in an emergency department: an observational evaluation study.
OBJECTIVE: To evaluate the utilisation of paper-based track and trigger (TandT) charts in a UK emergency department (ED). METHODS: A single-centre prospective observational cohort study was conducted in the ED of a medium-sized teaching hospital. Charted vital-sign data were collected from adults a...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2013
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| _version_ | 1797105962683727872 |
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| author | Wilson, S Wong, D Clifton, D Fleming, S Way, R Pullinger, R Tarassenko, L |
| author_facet | Wilson, S Wong, D Clifton, D Fleming, S Way, R Pullinger, R Tarassenko, L |
| author_sort | Wilson, S |
| collection | OXFORD |
| description | OBJECTIVE: To evaluate the utilisation of paper-based track and trigger (TandT) charts in a UK emergency department (ED). METHODS: A single-centre prospective observational cohort study was conducted in the ED of a medium-sized teaching hospital. Charted vital-sign data were collected from adults attending the resuscitation room, majors or observation ward. These data were examined in parallel with clinical notes to identify 'escalation' events. For each set of vital signs, the authors calculated the TandT score retrospectively. RESULTS: Data from 472 patient episodes (2965 sets of vital signs) were examined. 85.8% of patients had at least one full set of observations (CEM standard) and 60.6% had at least one TandT score documented. However, only 34.5% of observation sets had a corresponding TandT score. 20.6% of TandT score totals (1024) were incorrect, potentially preventing a 'trigger' from being recognised. 204 patient episodes had at least one recorded escalation. Physiological escalations were associated with vital-sign scores that met the triggering thresholds (98/104), while patients who had non-physiological escalations or no escalations were more likely to have scores below the triggering thresholds (88/100). Only 26.9% of physiological escalations were associated with a documented TandT score above the triggering threshold. Retrospective completion of the charts increased that figure to 94.2%. CONCLUSION: TandT in the ED is challenged by poor completion rates and numerical errors made during score calculation. However the potential for recognition of a deteriorating patient should not be ignored. The future work of the authors intends to evaluate an electronic system for automatically calculating TandT scores within the ED environment. |
| first_indexed | 2024-03-07T06:54:53Z |
| format | Journal article |
| id | oxford-uuid:fdcc29d6-820a-4a8c-b1c5-39eed0210996 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:54:53Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:fdcc29d6-820a-4a8c-b1c5-39eed02109962022-03-27T13:31:32ZTrack and trigger in an emergency department: an observational evaluation study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fdcc29d6-820a-4a8c-b1c5-39eed0210996EnglishSymplectic Elements at Oxford2013Wilson, SWong, DClifton, DFleming, SWay, RPullinger, RTarassenko, L OBJECTIVE: To evaluate the utilisation of paper-based track and trigger (TandT) charts in a UK emergency department (ED). METHODS: A single-centre prospective observational cohort study was conducted in the ED of a medium-sized teaching hospital. Charted vital-sign data were collected from adults attending the resuscitation room, majors or observation ward. These data were examined in parallel with clinical notes to identify 'escalation' events. For each set of vital signs, the authors calculated the TandT score retrospectively. RESULTS: Data from 472 patient episodes (2965 sets of vital signs) were examined. 85.8% of patients had at least one full set of observations (CEM standard) and 60.6% had at least one TandT score documented. However, only 34.5% of observation sets had a corresponding TandT score. 20.6% of TandT score totals (1024) were incorrect, potentially preventing a 'trigger' from being recognised. 204 patient episodes had at least one recorded escalation. Physiological escalations were associated with vital-sign scores that met the triggering thresholds (98/104), while patients who had non-physiological escalations or no escalations were more likely to have scores below the triggering thresholds (88/100). Only 26.9% of physiological escalations were associated with a documented TandT score above the triggering threshold. Retrospective completion of the charts increased that figure to 94.2%. CONCLUSION: TandT in the ED is challenged by poor completion rates and numerical errors made during score calculation. However the potential for recognition of a deteriorating patient should not be ignored. The future work of the authors intends to evaluate an electronic system for automatically calculating TandT scores within the ED environment. |
| spellingShingle | Wilson, S Wong, D Clifton, D Fleming, S Way, R Pullinger, R Tarassenko, L Track and trigger in an emergency department: an observational evaluation study. |
| title | Track and trigger in an emergency department: an observational evaluation study. |
| title_full | Track and trigger in an emergency department: an observational evaluation study. |
| title_fullStr | Track and trigger in an emergency department: an observational evaluation study. |
| title_full_unstemmed | Track and trigger in an emergency department: an observational evaluation study. |
| title_short | Track and trigger in an emergency department: an observational evaluation study. |
| title_sort | track and trigger in an emergency department an observational evaluation study |
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