Capsule Commentary on Ratelle et al., Predicting and Communicating Risk of Clinical Deterioration: An Observational Cohort Study of Internal Medicine Residents

Excerpt

The study by Ratelle et al.1 evaluated the ability of Internal Medicine residents to use a clinical prediction tool, the Patient Acuity Rating (PAR),2 to identify patients at risk for clinical deterioration. By evaluating the level of agreement between independently derived PAR scores of residents participating in a patient handoff, the study also investigated how effectively the residents communicated the potential for clinical deterioration. The authors found that higher PAR scores were associated with a significant increase in the odds of clinical deterioration, which is consistent with the findings of the original PAR study.2 Among post-graduate year (PGY) 1 residents, there was fair agreement in PAR scores between the giving and the receiving resident after a handoff. Interestingly, the level of agreement of PAR scores was lower among PGY3 residents, with higher average PAR scores by residents receiving the handoff. …