New tool will help clinical staff intervene earlier when a patient’s condition worsens

In 2011, Yale New Haven Hospital was among a handful of hospitals nationwide to pilot the Rothman Index, a tool designed to help clinical staff intervene earlier when a patient’s condition begins to worsen.

For years, Yale New Haven Health has used the Rothman Index and another tool, the Epic Deterioration Index, to reduce complications and save lives. But a review of past cases showed a need for a different tool – one that would support even earlier and more accurate identification of patients whose conditions are deteriorating.

This month, YNHHS is scheduled to launch eCART at Yale New Haven Hospital. The tool will be phased in at all Yale New Haven Health hospitals over the spring. It will replace the Epic Deterioration Index and Rothman Index.

YNHHS decided to implement eCART after an extensive analysis of patients throughout the health system who experienced clinical deterioration. The analysis, which compared eCART to the Rothman Index and Epic Deterioration Index, showed that eCART was significantly more precise in predicting all-cause deterioration in patients.  

The Rothman Index combines 26 variables – including vital signs, certain lab test results and clinician assessments – to create a score indicating a patient’s likelihood of deteriorating. ECART uses 97 variables, along with artificial intelligence and other functions, to generate a score.  

ECart also: 

• Will be integrated with nursing and physician workflows (clinical pathways) to help create standardized approaches to managing patients whose conditions are deteriorating.  
• Continuously recalculates the probability of deterioration, from a patient’s admission through discharge.
• Generates data that will help individual units, hospitals and the health system improve their responses to clinical deterioration.

Watch for detailed training materials and other information about the eCART launch.