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Invited Commentary
December 8/22, 2008

Integrated Monitoring Systems and Patient SafetyA Need for Further Study—Invited Commentary

Arch Intern Med. 2008;168(22):2404. doi:10.1001/archinte.168.22.2404

Patient safety is a fundamental responsibility of health care and, in the current era, is an increasingly studied and critiqued component of hospital care. Hospitalized patients generally receive care and monitoring far superior to that received by patients outside the hospital, but paradoxically, patients admitted to medical wards and who later deteriorate and enter an intensive care unit (ICU) have worse outcomes than those admitted directly to an ICU through emergency departments.1 Causes for worse outcomes could include delayed recognition of clinical deterioration and then delayed initiation of time-sensitive therapies (such as early goal-directed therapy for sepsis or early intervention for myocardial infarction). Common anecdotal experiences of critical care physicians and retrospective study reveal that clinically significant documented vital sign instability can exist hours or days before patients are ultimately admitted to the ICU.2

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