Evaluation of Automated Alert and Activation of Medical Emergency Team in Head and Neck Cancer Patients Using Early Warning Score at Tertiary Level Hospital in North India

Background: Improved patient safety for those undergoing treatment of head and neck cancers depends on prompt identification of warning indicators from severely critical patients and appropriate treatment. As a result, many hospitals all around the world have implemented quick response techniques, including medical emergency teams (MET), which have systems and personnel that are highly trained to deal with patients who are deteriorating. Nowadays, automated activation and alert programs are also being discussed. Aim: To compare the patient outcomes in two conditions: one before the application of the automated MET alert and activation program and the other after the application of the automated MET alert and an activation program was used. Methods and Materials: There was an examination of clinical data on MET-managed patients before and after the computerized alert and activation approach was put in place. The study comprised all adult head and neck cancer patients who were treated by the MET between March 1, 2017, and December 31, 2021. The physiologic abnormalities of the patient at the moment of the MET initiation were recorded as causes for MET activation when the MET was alerted by the computerized alert, and activation system. From activation through deactivation, the MET intervention lasted. Hospital mortality served as the study's primary outcome. The duration of stay at the hospital and unscheduled ICU hospitalizations were secondary outcomes. Medical records from hospitals were examined retrospectively to get information on clinical outcomes. Results: The percentage of unplanned admissions in ICU was greater in the pre-implementation stage (22.34%) as compared to that in the post-implementation stage (13.56%) (p value<0.001). The duration of stay of patients at the hospital also got reduced in the post-implementation phase (13.23 ±1.47 days) as compared to the pre-implementation stage (24,76± 1.12 days) (p<0.001). The median time of derangement of activation of MET was greater in the pre-implementation stage (62 minutes) as compared to the post-implementation stage (34 minutes) (p-value <0.001). The most common complications leading to MET activation in a pre-implementation phase were neurological and respiratory complications. On the other hand, overall deterioration was the most common cause of MET activation. The mortality rate of patients in the pre-implementation stage was 36.23% as compared to 22.12% in the post-implementation stage (p<0.001). Conclusion: The hospital experienced improved clinical outcomes with the adoption of an automated alarm and activation system using a cumulative weighted scoring methodology, which significantly reduced the time from disruption to MET activation.