Trial reportIntensive care medicine2004
Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital.
Trial report in Intensive care medicine, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02523456 (Develop, Implement and Assess Effectiveness of Early Warning Score), which is not on this map. Cited by 80 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Develop, Implement and Assess Effectiveness of Early Warning Score (EWS) for Moneragala District General Hospital
Who cites it
80 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Clinical Surveillance Technologies in Nonintensive Care Unit Hospital Settings: Systematic Review and Bayesian Network Meta-Analysis of Randomized Trials.Journal of medical Internet research · 2026Pooled it
- Early warning systems and rapid response systems for the prevention of patient deterioration on acute adult hospital wards.The Cochrane database of systematic reviews · 2021Pooled it
- Rapid response systems: a systematic review and meta-analysis.Critical care (London, England) · 2015Pooled it
- Protocolized versus non-protocolized weaning for reducing the duration of invasive mechanical ventilation in critically ill paediatric patients.The Cochrane database of systematic reviews · 2013Pooled it
- Rapid-response systems as a patient safety strategy: a systematic review.Annals of internal medicine · 2013Pooled it
- Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward.Intensive care medicine · 2007Pooled it
- The stepped wedge trial design: a systematic review.BMC medical research methodology · 2006Pooled it
- Investigating the effectiveness of critical care outreach services: a systematic review.Intensive care medicine · 2006Pooled it
- Effectiveness of rapid response teams in reducing intrahospital cardiac arrests and deaths: a systematic review and meta-analysis.Revista Brasileira de terapia intensivaPooled it
- Fluid balance control in critically ill patients: results from POINCARE-2 stepped wedge cluster-randomized trial.Critical care (London, England) · 2023Trial
- A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team.Journal of hospital medicine · 2014Trial
- The impact on patient health and service outcomes of introducing nurse consultants: a historically matched controlled study.BMC health services research · 2013Trial
- Technical Approaches to Predicting Acute Deterioration in Pediatric Inpatients: Protocol for a Scoping Review.JMIR research protocols · 2026Article
- Evaluation of injury prevention interventions using the stepped wedge cluster randomised trial design: key considerations.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2026Article
- What Evidence is Available on Rapid Response Systems Across Europe? Findings From a Scoping Review.Nursing in critical care · 2025Article
- Unplanned intensive care unit admissions in trauma patients: A critical appraisal.World journal of critical care medicine · 2025Article
- Dedicated rapid response team implementation associated with reductions in hospital mortality and hospital expenses: a retrospective cohort analysis.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
- Article
- The United Kingdom's National Early Warning Score: should everyone use it? A narrative review.Internal and emergency medicine · 2023Review
- Effect of the Ramathibodi Rapid Response System Triggered by the Ramathibodi Early Warning Score and Clinical Warning Signs on in-Hospital Mortality and the Incidence of Cardiopulmonary Resuscitation in Adult Hospitalized Patients.Therapeutics and clinical risk management · 2023Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose of the study was to investigate the effects of introducing a critical care outreach service on in-hospital mortality and length of stay in a general acute hospital.
designA pragmatic ward-randomised trial design was used, with intervention introduced to all wards in sequence. No blinding was possible.
settingSixteen adult wards in an 800-bed general hospital in the north of England. PATIENTS AND
participantsAll admissions to the 16 surgical, medical and elderly care wards during 32-week study period were included (7450 patients in total, of whom 2903 were eligible for the primary comparison).
interventionsEssential elements of the Critical Care Outreach service introduced during the study were a nurse-led team of nurses and doctors experienced in critical care, a 24-h service, emphasis on education, support and practical help for ward staff. MEASUREMENTS AND
resultsThe main outcome measures were in-hospital mortality and length of stay. Outreach intervention reduced in-hospital mortality compared with control (two-level odds ratio: 0.52 (95% CI 0.32-0.85). A possible increased length of stay associated with outreach was not fully supported by confirmatory and sensitivity analyses.
conclusionsThe study suggests outreach reduces mortality in general hospital wards. It may also increase length of stay, but our findings on this are equivocal.
Indexed as
Identifiers
15112033What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.