Integration of real-time patient vital signs into an electronic transport checklist to improve clinical decision-making and checklist responsiveness

This study aimed to evaluate whether integrating real-time vital signs into an electronic intrahospital transport checklist improves abnormal vital sign recognition time, clinical intervention response time, checklist completion efficiency, and transport-related safety outcomes. This prospective, before-and-after (quasi-experimental) observational study was conducted at a tertiary teaching hospital between January 2023 and December 2024. Adult patients requiring intrahospital transport with continuous physiological monitoring were included. Patients transported before June 2023 were managed using a conventional paper-based checklist, while those transported after implementation were managed using an electronic checklist integrated with real-time vital sign monitoring. Primary outcomes included abnormal vital sign recognition time, clinical intervention response time, and checklist completion time. Secondary outcomes included transport-related adverse events, checklist completion rate, and staff satisfaction. A total of 102 patients were included (49 conventional checklist group, 53 electronic checklist group). Baseline characteristics, including illness severity and transport complexity, were comparable between groups. The electronic checklist group demonstrated significantly shorter abnormal vital sign recognition time (16.9 ± 7.3 vs 34.6 ± 11.8 seconds, P  < .001), faster clinical intervention response time (61.3 ± 21.7 vs 88.7 ± 26.4 seconds, P  < .001), and reduced checklist completion time (97.2 ± 27.8 vs 126.4 ± 32.5 seconds, P  < .001). Transport-related adverse events occurred less frequently in the electronic checklist group (9.4% vs 16.3%), although this difference was not statistically significant ( P  = .38). Staff satisfaction scores were significantly higher in the electronic checklist group (4.3 ± 0.6 vs 3.5 ± 0.8, P  < .001). Integration of real-time vital signs into an electronic intrahospital transport checklist was associated with improved clinical responsiveness, faster intervention, and enhanced workflow efficiency. Given the before-and-after design, mixed timing methods, and limited power for safety endpoints, these findings should be interpreted as process-improvement associations rather than definitive causal evidence. Larger multicenter studies are needed to confirm whether these improvements translate into significant reductions in transport-related adverse events.