Situational Awareness and Emergent Response Systems in the Context of Stages of Clinical Deterioration in the Hospital

Situation Awareness (SA) refers to an individual's “perception of the elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future [1]”. SA failures have been very well studied in other high risk industries such as aviation that require an exceptionally high performance in a dynamic environment where safety is the primary emphasis [2]. Poor SA was found to be attributable to 88% of aviation accidents involving human errors [2]. Similarly, thousands of patients die every year in the United States due to preventable safety events [3]. Lack of SA and thereby inability to respond to critical situations in a timely manner is one of the leading causes for these safety events in health care. A shared understanding within the clinical team on current status and what's going to happen next is very important for timely intervention [4]. Hospitals employ a variety of systems to enhance this understanding and trigger appropriate emergent response for a critically ill patient.