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martes, 28 de enero de 2020

The Rothman Index

PulmCrit(EMCrit)
PulmCrit - January 25, 2020 - By Josh Farkas
"Summary: The Bullet
  • The Rothman Index is an early warning system which is integrated into the electronic medical record. It is similar to prior paper-based early warning systems designed to detect instability (e.g. NEWS), albeit with the addition of information from labs and nursing assessments.
  • The Rothman Index works well on paper as a predictive tool. However, recent evidence suggests that the Rothman Index fails to add true value in practice, for several reasons:
    • The Rothman Index often provides clinicians with information which is redundant to what they already know (e.g. alerts commonly occur after the treating team has already realized the patient is deteriorating).
    • The Rothman Index has limited predictive ability. In one study, the Rothman Index was no better than an intern at predicting patient deterioration. In another, only 29% of patients with cardiac arrest had a RI alert that day.
  • The Rothman Index does fill a void in the healthcare system, which is caused by lack of physician attention to nursing assessments. This is a problem, but there are better ways to fix it. The answer is probably for all of us to spend less time looking at computers – and more time talking with each other."