A. Rothman Institute, where he serves as President and CEO, and The Rothman Index.
According to Dr. Finlay, healthcare in the United States is beset by upward spiraling and financially unsustainable costs and quality that is disappointing at best. He says, “These pressures have led to a broad conclusion by Centers for Medicare & Medicaid Services, and the industry as a whole, that the system must change from the current fee-for-service payment model to a ‘value-based’ reimbursement model.”
Early efforts to address this issue have had inconsistent results in terms of both quality and cost measurements. Common to these approaches, and any others likely to be proposed, is that they are patient-centered and thus require a means to accurately measure and follow a patient’s overall condition at any level of care, from the acute care hospital through skilled nursing, home health care, and assisted and independent living organizations.
The Rothman Index
The Rothman Index is an acuity metric developed at Sarasota Memorial Hospital. The Index uses data empirically, associated with severity of illness, and automatically computed, using data routinely entered in the electronic medical record — including nursing assessments, Braden Scale score, cardiac rhythm, vital signs, blood oxygen level, and lab test results.
The Rothman Index has been validated with over 30 peer-reviewed articles and is used in over 60 hospitals nationwide, including Methodist Houston, the Yale New Haven Health System, and the University of Florida Hospitals. Preliminary studies in skilled nursing facilities appear to support its accuracy outside the hospital.
Plymouth Harbor’s Involvement
It has been speculated that a functionally equivalent index of acuity can be constructed for those persons living independently. Therefore, the Florence A. Rothman Institute is exploring a trial study whereby patients conduct their own medical self-assessments by answering a series of questions.
In April 2017, Dr. Finlay formally invited our independent living residents to participate in the study, working collaboratively with The Rothman Index and Sarasota Memorial Hospital. The study officially began on May 9, 2017, with 43 Plymouth Harbor participants.
About the Study
The study consists of 43 independent living volunteers who will answer ‘yes’ or ‘no’ to 14 questions about possible symptoms pertaining to their own body systems. Then, the same volunteers will have a Registered Nurse independently perform a “standard” head-to-toe nursing assessment for comparison. This assessment will be repeated on a second occasion separated by more than 24 hours.
This study is funded by the Florence A. Rothman Institute (www.farinstitute.org) under the auspices of the Institutional Review Board of Sarasota Memorial Healthcare System.
We hope to have results to share from this study in the coming weeks.