Safety Counts! a newsletter highlighting safety at Hallmark Health System

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Safety Counts June/July 2014 - Download entire PDF by clicking here. 

HHEWS comes to OB

Last year, Hallmark Health System (HHS) developed the Hallmark Health Early Warning System (HHEWS), which provides an objective analysis of inpatients at risk so appropriate action can be taken before a patient’s condition worsens. The tool tracks vital signs and the total score can guide clinical decision-making.

This spring, the tool was rolled out on the obstetrical unit (called MATHHEWS – MAT for maternity) at Melrose-Wakefield Hospital, though with a few tweaks. The OB team included additional “vital signs” such as bleeding and contractions. “We also added physician actions, such as when the physician needs to be at the hospital or review the fetal monitor strip,” said Carol Downes, MSN-MBA, RNC, BC-NEA, patient care director for maternal and newborn services.

In OB, MATHHEWS is a combined score (mother and baby). “Recently, we had a patient in labor who started to run a temperature and her baby’s heart rate increased,” said Downes. “Together, their score required action. We created and executed a plan and both mom and baby did fine.”

Currently, the MATHHEWS tool is applied to every patient – not just those considered to be at high risk – who is admitted to labor and delivery. “We opted to include everyone so we could maximize staff training during our pilot phase,” said Kati Roe, BSN, RNC, clinical practice leader for labor and delivery.

During the pilot, the tool has been tweaked further, incorporating feedback from physicians and nurses. One enhancement involves streamlining the documentation form; another includes an alert to postpone any scheduled procedure, such as an elective induction or C-section, when there are patients on the unit with a high MATHHEWS score. As a result, the tool “offers clearly defined data for medical and nursing staff,” said Roe. “No debate, no surprises.”


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