Mortality reduction associated with surveillance using an emr-based acuity score at an academic medical center

Conclusions Enhanced surveillance reduced mortality, and the nursing-based protocols were subsequently implemented throughout the hospital, and are being implemented throughout the 8-hospital system. Implications are that this approach will also aid in improving the general quality of care. Figure 1Monitoring protocols by clinician role fore patient surveillance at Houston Methodist Hospital "Graphs" below refer to Rothman Index graphs displayed on kiosks (monitors) at each nursing station, and in the EMR. Figure 2Houston Methodist alert rules and required nursing action. Rothman Index graphs are updated whenever new data is entered into the electronic medical record and a customized set of rules are evaluated to determine if a patient meets the criteria for an alert. Figure 1aA Rothman Index (RI) graph for a single patient. RI is on the y-axis, scale 0-100. For calibration: 100 is unimpaired, 65 is the acuity level typical for a patient discharged to a SNF, 40 is the acuity level when a physician might consider moving the patient to an ICU. Each dot reflects the score and the time when a new piece of data has been entered into the EMR and the RI was recalculated. Graphs are color-coded by the most recent score; below 40 the background of the graph is red, 40-65 it is yellow, and above 65 it is blue. Vertical lines are at midnights. This patient graph shows a 5-day history. RI has just fallen below 20, which triggered a "Very High Risk" alert. Figu...
Source: BMJ Quality and Safety - Category: Journals (General) Authors: Tags: Abstracts Source Type: research