TABLE 1.

Workgroups Established for Early Warning System Rollout

Workgroup	Goals
Clinical checklist	Perform structured chart review of selected unplanned transfer patients and near misses Develop a checklist for mitigation strategies given an alert Develop documentation standards given an alert Develop escalation protocol given an alert
Workload and threshold	Determine threshold for sensitivity of alerts and resulting impact on clinician workload
Patient preferences	Prepare background information to be presented to providers regarding end-of-life care and POLST orders Coordinate with clinical checklist workgroup to generate documentation templates that provide guidance for appropriate management of patients regarding preferences on escalation of care and end-of-life care
Electronic medical record coordination	Review proposed electronic medical record changes Make recommendation for further changes as needed Develop plan for rollout of new and/or revised electronic record tools Designate contact list for questions/issues that may arise regarding electronic record changes during the pilot Determine alert display choices and mode of alert notification
Nursing committee	Review staffing needs in anticipation of alert Coordinate with workload and threshold group Develop training calendar to ensure skills necessary for successful implementation of alerts Make recommendations for potential modification of rapid response team’s role in development of a clinical checklist for nurses responding to an alert Design educational materials for clinicians
Local communication strategy	Develop internal communication plan (for clinical staff not directly involved with pilot) Develop external communication plan (for nonclinicians who may hear about the project)

NOTE: Abbreviations: POLST, physician orders for life-sustaining treatment.