Hospitals in pursuit of excellence

Modified Early Warning Scoring System Incorporating the Severe Sepsis Screening Tool

Failure to rescue is the failure to recognize or act upon the patient's decline in condition resulting in death or permanent disability. In the United States between 2004 and 2006, 128 of every 1,000 patient deaths were attributed to failure to rescue. Review of literature indicates that patients show evidence of deterioration in condition well before cardiopulmonary arrest occurs. This may be due to: 1) Incomplete assessments and inadequate treatments; or 2) Failure to recognize early signs of deterioration. To reduce an identified high rate of code blue calls on a telemetry unit, the MEWS scoring tool including usage of the Severe Sepsis Screening Tool was implemented on that unit beginning May 2013. Applying a MEWS score to all patients every time vitals are taken allows nurses to identify changes in vital signs and patient condition and recognize opportunities for earlier intervention.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state.  These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)