Blessing Hospital launches the HART Program using the Rothman Index to help decrease mortality and code blues outside the ICU

Highlights for Blessing Hospital using The Rothman Index1

  • 35% reduction in overall mortality index
  • 34% reduction in code blues outside the ICU
  • 55 lives saved in one year using The Rothman Index
  • Initiated “HART” (High Acuity Response Team) program for critical care consult nursing team
  • Won 2019 Rothman Index Early Warning System Award
Blessing
blessing

Blessing Hospital, nestled along the banks of the Mississippi River in Quincy, IL, is the largest and oldest member of Blessing Health System, which also includes Blessing Corporate Services, Illini Community Hospital, Blessing Health Hannibal, Blessing-Rieman College of Nursing and Health Sciences, Denman Services Inc., and the Blessing Foundation. Since 1875, the people of west central Illinois, northeast Missouri, and southeast Iowa have trusted their healthcare to Blessing Hospital, a not-for-profit community hospital serving 21 counties and approximately 400,000 people. Blessing’s brand essence is providing patients a “True Human Connection.”

Challenge

Blessing Hospital wanted to reduce codes at their facility and created a rapid response team to identify patients and intervene earlier to prevent codes from occurring. As the concept of the rapid response team evolved, a pilot was created to standardize clinical processes that would help proactively identify patients at imminent risk of mortality. The pilot included using critical care nurses and nurse researchers led by Laura Wiegand, RN, BSN, CCRN. The group focused on evidence-based practice solutions that decrease the mortality of cardiopulmonary arrests outside the intensive care unit (ICU). The ultimate goals of the program were to decrease the number of codes outside the ICU by 20% and decrease the mortality index by 30%.

Solution

Blessing Hospital began using the Rothman Index in 2011 and has embedded Rothman Index processes into multiple clinical workflows. Blessing nurses use the Rothman Index during bedside rounding and shift reports.

The Rothman Index is the only scientifically validated clinical decision support platform that derives one simple score from the vast amount of data in the electronic medical record to create a picture of any patient’s condition over time – any age, any disease, any unit. It can detect patient deterioration hours or days earlier than existing scores and systems.

Blessing Hospital uses the Rothman Index to help decrease mortality and sustain those reductions. The team completed the pilot using a designated nurse from the rapid response team to monitor the patient’s trend and scores from the Rothman Index. This critical care consult nurse then completed rounds with bedside nurses to identify and discuss interventions of patients at risk.

Results

Overall, the implementation of a critical care consult nurse to promote early identification and intervention was successful in decreasing the hospital’s mortality index and the number of codes outside the ICU.

For the study, pre-implementation data demonstrated 8.05 per 1000 codes outside the ICU and a mortality index of 0.97. After a one-year pilot period, post-implementation data demonstrated a reduction to 5.31 per 1000 codes outside the ICU and a mortality index of 0.63. The hospital achieved an overall reduction of 35% in mortality index and 34% reduction in code blues outside the ICU, exceeding both outcomes’ goals.1

Blessing used the results of decreased mortality using The Rothman Index to make the business case to budget for the team of 13 Critical Care Consult Nurses, now known as the High Acuity Response Team, or HART.

The HART nurses use the Rothman Index as their primary assessment tool to proactively identify and intervene early with patients. Through better management of patients, the HART team documented helping save 55 patient lives from September 2018 – September 2019.

HART nurses now quantify their early interventions, then develop action plans with targeted education and mentoring for specific floors. Laura states, “The success of this program proves that when you have the right people equipped with the right tools, you can impact the quality of patient care and outcomes for patients.”

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1Goellner, Y., Tipton, E., Verzino, T., Weigand, L. (2022). Improving care quality through nurse-to-nurse consults and early warning system technology. Nursing Management, 53(1)

“The Rothman Index technology has been able to show HART is reducing unplanned transfers to the ICU and length of stay for the patients who are transferred.”

Laura Weigand – RN, BSN, CCRN, TNS Blessing Hospital Sepsis Coordinator and HART Team Lead

The HART nurses use the Rothman Index as their primary assessment tool to proactively identify and intervene early with patients. Through better management of patients, the HART team documented helping save 55 patient lives from September 2018 – September 2019.