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Impact of introducing an electronic physiological surveillance system on hospital mortality
  1. Paul E Schmidt1,
  2. Paul Meredith2,
  3. David R Prytherch2,3,
  4. Duncan Watson4,
  5. Valerie Watson5,
  6. Roger M Killen6,
  7. Peter Greengross6,7,
  8. Mohammed A Mohammed8,
  9. Gary B Smith9
  1. 1 Medical Assessment Unit, Portsmouth Hospitals NHS Trust, Portsmouth, Hampshire, UK
  2. 2 TEAMS Centre, Portsmouth Hospitals NHS Trust, Portsmouth, Hampshire, UK
  3. 3 School of Computing, University of Portsmouth, Portsmouth, Hampshire, UK
  4. 4 Intensive Care Medicine and Anaesthesia, University Hospitals, Coventry and Warwickshire NHS Trust, Coventry, UK
  5. 5 Critical Care Outreach, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  6. 6 The Learning Clinic, London, UK
  7. 7 Department of Primary Care and Public Health, Imperial College Healthcare NHS Trust, London, UK
  8. 8 Quality & Effectiveness, School of Health Studies, University of Bradford, Bradford, UK
  9. 9 School of Health & Social Care, University of Bournemouth, Bournemouth, UK
  1. Correspondence to Dr Paul Schmidt, Medical Assessment Unit, Portsmouth Hospitals NHS Trust, C Level, Queen Alexandra Hospital, Cosham, Portsmouth, Hampshire PO6 3LY, UK; Paul.Schmidt{at}porthosp.nhs.uk

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Shaw et al 1 are correct in pointing out that the use of a single year's mortality data as a baseline comparator could introduce bias to our findings. They and Van Schalkwyk2 are also right to highlight the national reduction in hospital mortality rates over the past decade. However, we did not rely solely upon the overall mortality reduction to come to the conclusion that there was an association between the timing of the introduction of an electronic physiological surveillance system (EPSS) and the reduced mortality at the two study hospitals.3

Both Shaw et al and Van Schalkwyk appear to ignore the significance of the main findings of our study. The reductions in annual observed deaths are concentrated in specific years (Portsmouth 2006 and 2009, years 2 and 5 after baseline; Coventry 2009, year 3 after baseline).3 Also, …

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