When looking at patient outcomes, it’s key to consider all areas that could negatively affect patient recovery, including those from unexpected sources. New research shows a surprising factor may play a role in medical setbacks for patients: witnessing other patients get worse in the hospital.
As described in a research letter published in the Journal of the American Medical Association (JAMA), researchers from the University of Chicago speculated that, when one patient’s health became critical enough to warrant being transferred to the ICU, other patients started experiencing similar issues.
And data backed up their belief.
Impact on patients’ health
According to a news release, researchers looked at data for a variety of patients from a normal 20-bed hospital unit at the University of Chicago Medicine over a four-year period. Specifically, they wanted to see whether “critical-illness events” like heart attacks had a significant impact on patient outcomes overall.
Their findings: In the six hours after a patient experienced an event such as cardiac arrest, the odds that a different patient from that unit would have a similar health crisis increased by 18%. And if two patients from the same ward had critical-illness events within a six-hour period, the odds of another event went up by 53%.
In either situation, the risks of a health crisis rose even higher if the events happened at night.
Critical-illness events such as urgent ICU transfers, cardiac arrests and patient deaths also affected other patients’ discharge times. Patients from units where a patient experienced one of these events were more likely to have a delayed discharge from the hospital.
Reasons why it happens
Researchers speculate that one reason why these patients may have a greater chance of suffering poor outcomes after one patient’s critical event is that they might receive less attention from doctors and nurses as they rush to handle the patient. So any changes to their conditions may not be discovered right away, allowing their health to quickly get worse.
To lessen the effects of this phenomenon, researchers said it’s crucial for hospital clinicians to step up their monitoring of all patients on a unit after one patient’s condition turns critical. After a critical-illness event, providers must assess each patient thoroughly to ensure his or her condition isn’t in danger of getting worse.
Providers can be even more proactive by closely monitoring patients who are more likely to experience a critical illness while hospitalized in the first place.
According to the JAMA research letter, patients who had to be transferred to the ICU or experienced cardiac arrest tended to be older males who had been in the hospital for an average of 13 days – longer than the typical stay of patients who didn’t experience a critical-illness event.
By reminding clinical staff to be more in tune with their patients on their units – especially if one suffers a heart attack or other critical event – hospitals can avoid a potential “domino effect” where multiple patients experience critical events at once.