Early warning systems and failure to rescue deteriorating patients

Failure to rescue (FTR) was initially coined as a metric to measure adverse events and outcomes in the post- surgical period. However, recent trends have shifted FTR away from its origin as a definitive outcome metric and instead place focus on the healthcare process factors that would lead to poor patient outcomes. While the inclusion of healthcare informatics, particularly Early Warning Systems (EWS), has targeted deteriorating patients as a priority, there remains much to be known about proper EWS implementation and the impact of human factors. Thus, the purpose of this study is to identify how EWS modulate barriers and facilitators of preventing failure to rescue. By performing a substantial literature review through CINAHL and PubMed databases, four key barriers and two key facilitators were found to impact rates of FTR. Interestingly, while many of these factors were rooted in human elements – communication, judgment, and fear – EWS provide useful routes for resolution of these issues. Ultimately, implementation of EWS can directly augment many of the vital characteristics of patient care, providing means for ease of communication, circumvention of interpersonal conflicts, and identification and treatment of the deteriorating patient. Through proper EWS implementation, frequency of FTR would decrease with patients experiencing reduced mortality and improved rates of successful interventions.