It’s called the “Watcher List” and simply put, it is for patients who need a little extra attention. Any physician, nurse or resident can place a patient on the Watcher List if they are concerned that patient may need a higher level of care. A patient on the list is given extra attention by care providers who have a plan in place should the patient’s condition deteriorate quickly.
“Generally the plan is to increase global awareness of these patients for an extra set of eyes,” said Chief Resident Tolulope Adebanjo. “Each week there is a safety resident who oversees the Watcher List for each unit ensuring the proper steps are taken to escalate care for a patient should it become needed.”
The program was enacted by the quality and safety team as a measure to increase patient safety. It began as a pilot program on a few units and expanded to a system-wide acute care initiative. Since going into effect, the number of codes on each floor have dramatically decreased. The new system allows for the rapid response team (RRT) to be called into action more quickly and efficiently before a patient decompensates.
“For our nurses, the Watcher List allows for peace of mind knowing the entire care team is aware of the patients who may require the most attention on the unit and that there is a plan to ensure the patient receives the appropriate care,” said Assistant Clinical Director of Inpatient Nursing Monica Simmons. “The nurses have the most interaction with the patients and play a key role in communicating with the care teams about each of these patients.”
“The key to good patient care is communication so the Watcher List is one way that we communicate our level of concern about patients,” said Chief Resident Kim Lehecka. “It’s a really systematic way to communicate concerns easily and efficiently while being able to quickly prioritize.”
Patients on the Watcher List have a greater chance of being moved to a higher acuity unit. The criteria for the list varies from floor-to-floor and may include abnormal vital signs, abnormal labs, a patient on high risk medication and a variety of other causes. The list is available for teams across the organization and helps coordination across units when a patient may need to be moved. Higher acuity units are in constant communication with the others on what the needs may be throughout any given day.
“It’s a common language,” Adebanjo said. “It’s a patient who needs to be frequently assessed with the potential to get really sick very quickly.”
The list allows a greater preparation for adverse events and a plan of action that could mean a better outcome. The charts on each patient shows the reasons they are on the Watcher List as well as the plans of action should the RRT need to be called. A patient is taken off of the list when their condition improves, but not without a conversation between a multidisciplinary team.
