• Am J Med Qual · Nov 2014

    Use of the modified early warning score and serum lactate to prevent cardiopulmonary arrest in hematology-oncology patients: a quality improvement study.

    • Robert S Young, Barbara H Gobel, Mark Schumacher, Jungwha Lee, Charlotta Weaver, and Sigmund Weitzman.
    • Northwestern University Feinberg School of Medicine, Chicago, IL r-young@northwestern.edu.
    • Am J Med Qual. 2014 Nov 1; 29 (6): 530-7.

    AbstractThis 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. © 2013 by the American College of Medical Quality.

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