Implementation of a risk stratification tool in the Surgical Intensive Care Unit (SICU) to reduce patient readmission after transfer to medical/surgical units

Purpose of the Project: This quality improvement project aimed to evaluate whether implementing the Early Warning Score (EWS) tool could decrease the Surgical Intensive Care Unit (SICU) readmission rate.Methods: This project was conducted at a large, academic Level 1 trauma medical center in northern New Jersey. The population included trauma and surgical patients admitted to the SICU and who were subsequently transferred to medical-surgical units and readmitted within 72 hours. The intervention included educating nurses and providers on the EWS tool and using the scores to guide transfer decisions. Data was collected over 16 weeks (eight pre-implementation and eight post-implementation). Results: A total of 258 patients met the project's inclusion criteria (126 in the pre-implementation; 132 in the post-implementation period). A total of seven (5.6%) patients were readmitted to SICU pre-implementation, and five (3.8%) after implementation. Although the difference was not statistically significant (p=0.5), the project demonstrated a 32% relative reduction in SICU readmissions following the EWS implementation. Implication for Practice: The project's outcome was not statistically significant. The low participation rate, small sample size, and short duration may have contributed. However, the 32% relative reduction rate suggests that using the EWS tool before transfer is valuable.