From the Journal: Ascension sustains reduction in mortality across 88 hospitals with Recognize and Rescue
Ascension reduced risk-adjusted mortality by more than 20% across 88 hospitals through its Recognize and Rescue initiative. This major breakthrough in patient care is reported in the March issue of The Joint Commission Journal on Quality and Patient Safety. Over a three-year period, the program prevented more than 4,000 deaths, focusing on standardizing processes, feedback on performance, and accountability.
Ascension’s approach of standardizing care and mitigating risk for events (Recognize) and prompt management of the decompensating patient (Rescue) provides a foundation for anchoring standardized processes in care, reducing variation, and promoting optimal outcomes through a multidisciplinary approach that included physicians, nursing, and other medical professionals. Under the Rescue work, the authors promoted teamwork, enhanced the function of rapid response teams to a proactive role to avert significant patient deterioration, and established a clear approach to escalation of care and resuscitation.
This systemwide initiative and was associated with sustainable improvements in mortality and a reduction in infectious and safety events, specifically:
- Overall mortality improved from the baseline of 0.97 in 2021 to 0.74 in 2023
- Standardized infection ratio declined (in 2023 compared to 2021) for:
- Central line-associated blood stream infections by 24.8%
- Catheter-associated urinary tract infections by 30.6%
- Hospital onset (HO) methicillin-resistant Staphylococcus aureus bacteremia by 29.0%
- HO Clostridioides difficile infection by 35.1%
- HO acute kidney injury (AKI) episodes dropped by 6.2%
- Patient-days with hypoglycemia and severe hyperglycemia decreased by 5.8% and 22.8%, respectively
Significant improvements in healthcare-associated infections were noted for both 2022 and 2023. Ascension markedly exceeded the U.S. national performance for the four healthcare-associated infections. The successful outcomes were related to promoting healthcare worker competencies to mitigate device harm of peripheral and central venous catheters and urinary catheters and promoting diagnostic stewardship.
Ascension has seen improvements in all of its 11 geographically distinct markets, reflecting the feasibility of implementing such effort in other systems. Many of Ascension’s markets have different cultures, environments, and resources.
Read the Becker’s Clinical Leadership article highlighting the study