IMPROVING RESCUE

Every year at least 100,000 Americans die undergoing inpatient surgical procedures and another 100,000 patients die while hospitalized for a medical illness. Wide variation in mortality rates across hospitals suggests substantial opportunities for improvement. Several decades of patient safety work have been focused on preventing complications in an effort to ultimately reduce mortality. However, these efforts have not had a significant impact and there is growing recognition that high mortality and low mortality hospitals are distinguished less by their complication rates than by how successfully they recognize and manage complications once they occur. Thus, minimizing failure to rescue (FTR) defined as death following a major complication, is critical to reducing mortality in hospitalized patients.

Our project, the FTR Patient Safety Learning Lab at Dartmouth-Hitchcock Medical Center is focused on creating the ideal hospital rescue system. The focus will be on early “upstream” recognition and management of non-preventable complications. Studies will target gaps in two interconnected systems: 1) understanding the technology factors behind ideal risk assessment/surveillance supporting early detection of complications and, 2) the human factors that support the ideal individual and team response in effectively managing these complications. Once these gaps are identified and understood, we will use a novel translation approach to rapidly integrate and translate new knowledge into an ideal system for rescue that collectively supports reliable “early” rescue.