Abstract |
This process improvement project aimed to improve the early identification of clinically deteriorating hematology-oncology patients in order to prevent the development of critical illness and to facilitate timely intensive care unit (ICU) transfers. Using failure modes and effects analysis, a protocol employing the Modified Early Warning Score and serum lactate level was implemented to identify deteriorating patients who required the attention of the rapid response team. Control charts revealed a significant decrease in codes and preventable codes, while ICU transfers remained stable. A retrospective analysis to control for age, sex, race, severity of illness, and do not resuscitate status was performed, yielding a codes odds ratio of 0.51 (95% confidence interval = 0.31-0.85) and a preventable codes odds ratio of 0.25 (95% confidence interval = 0.07-0.82). At the study team's institution, implementation of this protocol reduced codes and preventable codes without an associated increase in ICU transfers.
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Authors | Robert S Young, Barbara H Gobel, Mark Schumacher, Jungwha Lee, Charlotta Weaver, Sigmund Weitzman |
Journal | American journal of medical quality : the official journal of the American College of Medical Quality
(Am J Med Qual)
2014 Nov-Dec
Vol. 29
Issue 6
Pg. 530-7
ISSN: 1555-824X [Electronic] Netherlands |
PMID | 24202295
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Copyright | © 2013 by the American College of Medical Quality. |
Chemical References |
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Topics |
- Biomarkers
(blood)
- Early Diagnosis
- Female
- Healthcare Failure Mode and Effect Analysis
- Heart Arrest
(prevention & control)
- Hematologic Diseases
(complications)
- Hospital Rapid Response Team
- Humans
- Intensive Care Units
- Lactic Acid
(blood)
- Male
- Middle Aged
- Neoplasms
(complications)
- Patient Transfer
- Quality Improvement
- Retrospective Studies
- Severity of Illness Index
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