Identifying Preventable Patient Health Issues

Key Takeaways:

  • Data-rich rounding processes can be used to improve patient safety, decrease mortality and reduce LOS for chronically ill patients in an ICU environment.
  • The new model called Leadership, Ownership, Transformation, Unity and Sustainability (LOTUS) identifies factors which can reduce ICU admissions.

The LOTUS model was recently developed at a 250-bed hospital which had recently been acquired. Seeing as the ICU was not meeting expectations for quality metrics, ‘The unit’s nursing leadership, in partnership with leadership from each discipline, seized the opportunity to address the team dynamics and rounding process to assure that accountability could be demonstrated through reliable quality metric data assessment,’ state the authors. ’Simultaneously, the unit’s nursing leadership was charged with capturing care delivery quality metrics for the system-wide ICU report card’1.

‘Faced with two parallel priorities, the clinical director formed a small workgroup and developed a daily rounding tool to align each initiative and capture real-time activity,’ added the authors. ‘Key data points would be collected during daily rounds to capture real-time information and minimize labor-intensive manual data retrieval’1.

In doing so, the organization transitioned from ‘a model that was fragmented and sometimes strayed from keeping the patients’ own wishes central to the decision-making process—and developed one that is much more efficient, thoughtful and deliberative,’” said lead researcher Liza Barbarello Andrews, and critical care pharmacy specialist at the organization1.

‘Many patients present with life-threatening complications due to failure to take their diabetes or blood pressure medications,’ she added. ‘We would treat the resulting problem, but hadn’t been routinely investigating what led to the issue or designed a solution to prevent it from happening again in the future. Under the LOTUS model, by focusing on the patient perspective, we discovered that some patients had received confusing, mixed messages about the medicine from their healthcare providers. Other patients were struggling with financial or emotional problems that made self-care difficult.’”1

In case you missed it:


1Slabodkin, G. (March 25th, 2019) ICU Model Helps Hospital Identify Preventable Patient Health Issues .


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