TY - JOUR
T1 - Use of the Modified Early Warning Score and Serum Lactate to Prevent Cardiopulmonary Arrest in Hematology-Oncology Patients
T2 - A Quality Improvement Study
AU - Young, Robert S.
AU - Gobel, Barbara H.
AU - Schumacher, Mark
AU - Lee, Jungwha
AU - Weaver, Charlotta
AU - Weitzman, Sigmund
N1 - Publisher Copyright:
© 2013 by the American College of Medical Quality.
PY - 2014/11/8
Y1 - 2014/11/8
N2 - 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.
AB - 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.
KW - clinical deterioration
KW - modified early warning score
KW - oncology care
KW - serum lactate
UR - http://www.scopus.com/inward/record.url?scp=84908498583&partnerID=8YFLogxK
U2 - 10.1177/1062860613508305
DO - 10.1177/1062860613508305
M3 - Article
C2 - 24202295
AN - SCOPUS:84908498583
SN - 1062-8606
VL - 29
SP - 530
EP - 537
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
IS - 6
ER -