Deterioration Index Will Help Prevent Adverse Outcomes for Patients

October 11, 2020
Deterioration Summary report POC

On October 13, NHRMC will implement the Deterioration Index predictive model, an Epic-based tool that will alert clinicians when a patient's condition begins to deteriorate. This new tool will enable staff to identify deterioration sooner and has the potential to prevent adverse outcomes and even death.

Patients who experience certain medical situations, such as a rapid response or a code blue, have a significantly increased risk of mortality. Often, these patients exhibit subtle signs of clinical deterioration up to 24 hours prior to the need for intensive intervention.  Early detection of clinical deterioration using predictive analytics, coupled with active clinical decision support, may increase early clinical evaluation and treatment, improving quality and patient safety.  

Dr. Amy Messier helped bring this innovative predictive model to NHRMC. We looked at outcome metrics reported by other Epic organizations, evaluated our own internal NHRMC data and recognized an opportunity to improve patient outcomes.

The new process underscores several of the Commitments related to NHRMC's Vision for the future — Exceptional Quality, Health & Vitality for All, and Transformation through Empowerment and Innovation.


The model evaluates 125 data points, including demographic information, vital signs, lab results, and nursing assessments to calculate the score. When a patient’s deterioration index score reaches 60, the primary nurse will receive a Rover notification and a Best Practice Advisory in Epic Hyperspace. At a score of 60, a patient has an 80% chance of experiencing an adverse event and may need early intervention.


A CBL is available in NetLearning and a tip sheet is attached.