A multidisciplinary rounding tool was developed to standardize rounds—and keep track of the "hawks" and "doves"—using an EHR system. And, wireless communication devices were used for "real-time communications" between hospitalists and other stakeholders.
Based on the reduction in hospital mortality observed in this pilot and in the prior New York studies, Ravikumar estimates that an 18% to 25% reduction in hospital mortality could occur through these changes in the system. If this figure were stretched out nationally, this system redesign could have the potential to save up to 95,000 lives a year if adopted, he adds.
While small, incremental costs are involved in additional staffing, this is overshadowed by financial savings in length of stay reduction, optimization of resource utilization, and averting complications, Ravikumar says.
"The strength of this project is not just giving [hospitals] a cookie cutter approach, It's giving them principles," he said. "Each hospital has to use its own principles to adapt to its own micro-environment to do better every year."
This means that each hospital needs to look at its own mortality data to see where additional efforts are needed to protect patients, he says. For instance, one hospital may be good at managing morbidly obese patients while another may not: that latter hospital would need to find better ways to address the healthcare needs of those patients to keep mortality rates down.
"The basic principal is that...hospitals need to function in a safer zone than they do. Everyone wants to do it. Everyone wants to prove that. That's system redesign," said Ravikumar.