Failure to Rescue (FTR) in hospitalised adult patients, understood as preventable clinical deterioration that may lead to in-hospital mortality or serious adverse events (functional decline, sepsis, cardiac arrest, unplanned transfer to the ICU, or other complications). The study examines the clinical, functional, and organisational determinants of this phenomenon as a key indicator of patient safety and quality of care. Other
Conditions
Interventions
This is a retrospective observational study based on electronic health records of adult patients admitted to University Hospital La Plana between March 2023 and February 2024.
Variables collected in
voluntary discharge
transfer to another hospital
transfer to another ward
death
other).
3. Functional assessment: VALENF instrument (7-item meta-instrument assessing functional capacity, risk of falls, and risk of pressure injuries), overall score and items collected at admissio
Sponsors
Universitat Jaume I
Eligibility
Sex/Gender
All
Age
18 Years to 101 Years
Inclusion criteria
Inclusion criteria: 1. Adult patients (=18 years) admitted to the medical–surgical hospital wards of University Hospital la Plana. 2. Admission between 1 March 2023 and 29 February 2024 3. Length of hospital stay >48 hours
Exclusion criteria
Exclusion criteria: 1. Patients admitted to special units (ICU, emergency department, operating theatre and recovery room, maternal and child unit, or home hospitalisation) 2. Patients with a single care episode lasting less than 48 hours
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Occurrence of Failure to Rescue (FTR), defined as the presence of at least one of the following events measured using patient records: 1. Functional decline defined as a >20-point decrease in the VALENF functional capacity score, or as a discharge score <60 in patients aged =80 years 2. In-hospital mortality, unplanned ICU admission, urgent surgery, urgent interhospital transfer, cardiac arrest, sepsis, or prolonged length of stay (measured during hospitalization). 3. Readmission within 7 days after hospital discharge. | — |
Secondary
| Measure | Time frame |
|---|---|
| Different dimensions of Failure to Rescue (FTR) measured using patient records: 1. Sociodemographic, functional, physiological, laboratory, and process-of-care variables associated with the occurrence of FTR, measured using clinical records and the VALENF instrument, assessed during hospital stay. 2. Temporal evolution of functional capacity, measured using the VALENF instrument during hospitalization. 3. Temporal evolution of physiological parameters, measured using standard clinical monitoring (vital signs, hemodynamics) during hospitalization. 4. Dynamics of laboratory markers related to inflammation, infection, renal, cardiac, and metabolic function, measured using routine laboratory tests within the first 48–72 hours after admission or surgery. 5. Comparison of predictor variables across different types of FTR events (mortality, unplanned ICU admission, urgent surgery, or sepsis), measured using hospital records at index hospitalization. 6. Deviations in care process sequences, measured using process mining techniques applied to electronic health records, assessed during hospital stay. 7. Predictive performance of machine learning and process mining models for detecting FTR, evaluated for reliability and accuracy using internal validation datasets. | — |
Countries
Spain
Contacts
Public ContactMaría Jesús Valero-Chillerón
Outcome results
None listed