thesullivangroup.com 855.RSQ.INFO Empowering Clinicians with Risk, Safety, Quality Solutions

RSQ® Solutions

In the course of partnering with one of the largest healthcare systems in the United States, The Sullivan Group gathered data showing that 19% of patients were being discharged from emergency departments across the system with very abnormal vital signs. Because such patients have an increased risk for morbidity and mortality, the health system’s exposure to potential medical malpractice claims increased from these medical errors.

By implementing The Sullivan Group’s RSQ® Solutions - Emergency Medicine Program, the healthcare organization significantly reduced the percentage of patients discharged with very abnormal vital signs. In conjunction with the reduction of this medical error, the system saw significantly reduced medical malpractice claims filed against their emergency departments.

Eliminating Inappropriate Discharge of Patients with Very Abnormal Vital SignsThe Systematic Approach to Re-Evaluation

Reduction in frequency of ED claims over a 10-year period

60%YEARYEARYEARYEARYEAR

Discharged with very abnormal vital signs

1%22% improvement over course of program

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thesullivangroup.com 855.RSQ.INFO Empowering Clinicians with Risk, Safety, Quality Solutions

RSQ® Solutions

Committed to Quality CareA large health system engaged The Sullivan Group to identify areas of opportunity to reduce medical errors made in their emergency departments. A preliminary clinical performance analysis revealed 19% of the patients with very abnormal vital signs to have been discharged without a documented re-evaluation of their vital signs.

RSQ® Cycle Drives ChangeThe organization implemented The Sullivan Group’s RSQ® Solutions - Emergency Medicine Program. The solution consists of:

Online Case-Based Learning with RSQ® Education - Clinicians engage in online CME/CE courses based on real cases to raise awareness of the frequency of the medical error of discharging patients with very abnormal vital signs and the risks associated with it.

Bedside Clinical Decision Support with RSQ® Modules for EMRs – The organization enhanced its existing documentation tool, providing an area where the physician and nurse can verify that a re-evaluation of vital signs was performed prior to discharging the patient. An alert also provides enhanced support to prevent a patient with very abnormal vital signs from being discharged.

Clinical Performance Analytics with RSQ® Assessment – A granular analysis of patient records subsequently determines how consistently very abnormal vital signs are re-evaluated prior to discharge. Analytics are provided at both the individual and institutional levels to measure improvements and positive changes in the clinical practice of the emergency department staff.

Improving Outcomes with a System-Wide SolutionAfter implementing the RSQ® Solutions - Emergency Medicine Program, the health system showed an immediate reduction in the number of patients discharged with very abnormal vital signs. By applying the cyclic solution, the percentage of patients discharged with a re-evaluation of vital signs improved from 81% to 99%.

RSQ® Modules for EM

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RSQ® Cycle

1Q‘03 3Q‘03 3Q‘04 3Q‘05 3Q‘06 3Q‘07 3Q‘08 3Q‘09 3Q‘10 18% improvement in points, 22% improvement overall

Reduction in Malpractice Claims*Per 100,000 Visits

% of Patients Discharged with a Re-Evaluation of Vital Signs

‘96 ‘97 ‘98 ‘99 ‘00 ‘01 ‘02 ‘03 ‘04 ‘05 ‘06 ‘07 ‘08 ‘09

10

8

6

4

2

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22%Improvement

8184

89 88

9296 96

9995

8.5 9.28.1

7.7 7.8 7.86.9

5.84.6 4.5 4.4

3.8 4.03.1

60%Reduction