Background: The Modified Early Warning Score (MEWS) is a physiological scoring system developed to identify patients in early stages of clinical deterioration and prevent delays in proper care. It consists of systolic blood pressure, heart rate, respiratory rate, temperature and level of consciousness. Higher MEWS are associated with greater mortality and need for intensive care. [...]

Background: A LEAN principle is that front line staff provide value as defined by the customer (the patient). Within a LEAN framework, an A3 is both a way to understand your problem and a tool to organize multiple PDSA cycles into one cohesive and visible structure. While the literature cites many examples of PDSA cycles [...]

Background: Code Blue events, or in-hospital patient emergencies, often require advanced cardiac life support (ACLS) and unfortunately can end in loss of life. Defining and measuring outcomes is an essential step for improvement in any process, but especially for a process as critical as Code Blues.  In our institution, Code Blues are run by a [...]

Background: Hospital based providers are often tasked with leading cardiopulmonary arrest resuscitations known as code blues. This responsibility can be stress provoking and poorly executed without appropriate training resulting in poor patient outcomes. At our academic medical center, internal medicine residents on their inpatient hospital based rotations are responsible for this assignment. The process of [...]