Predictive Data Cuts Mortality by 30%
Yale New Haven Hospital's nurse SWAT team goes beyond just responding to changes in patients' status. It uses predictive data to anticipate problems, and intervenes at the earliest signs of decompensation.
Go with your gut. How often have you heard that advice about relationship, career, or parenting concerns?
Some of us have more accurate gut instincts than others. We get that feeling that something is right, or wrong—like when we somehow "know" to avoid an intersection just moments before an accident occurs—but we're not sure why.
I used my gut instinct often when I worked on a neuroscience unit many years ago. Sometimes something just seemed off about a patient, even though their vital signs were stable, and they knew who they were, where they were, and what year it was.
In fact, one of my strongest memories of my time there was when I called the neurosurgery team near the end of a 12-hour shift because I felt that my patient—an elderly gentleman who had slipped on ice, fallen, had a sustained a small subdural hematoma a few days prior—wasn't quite himself.
He was a gregarious guy and was quite skilled in providing non-answers to my questions by turning his responses into jokes. He managed to convince the residents, the attending, and his family that he was fine. The medical team left in a huff, annoyed at my "overreaction."
Still, as I gave my report in preparation to go home, I advised my night shift relief to "keep an eye on him because something was up." And I was right. He ended up having a seizure in the middle of the night and became combative.
Had this happened today, rather than a decade and half ago, I might have had the ability to use predictive data to support my hunch and to persuade the neurosurgeons to take action before the patient deteriorated.
The nurses at Connecticut's Yale-New Haven Hospital have been doing just that through the use of a nursing SWAT team and predictive data.
Refining Rapid Response Teams
I'd describe the way YNHH is using the combination of a SWAT team and predictive data as two steps beyond the typical use of Rapid Response Teams. RTTs came into vogue around 2005 when the Institute for Healthcare Improvement included them as one of six recommended interventions to improve patient safety during its 100,000 Lives Campaign.