It’s a DOBUTAful Day to Save Lives

At Methodist Hospital in San Antonio, Texas, the American Association of Critical-Care Nurses (AACN) Clinical Scene Investigator (CSI) team in the cardiac progressive care unit focused on evidence-based strategies to reduce rapid response team (RRT) activations and transfers to a higher level of care among patients with heart failure. The team also wanted to improve the unit’s AACN Healthy Work Environment Assessment Tool (HWEAT) scores.The CSI team used AACN’s HWEAT to assess team dynamics among staff, leaders, and physicians. The initial survey results identified opportunities for improvement in 2 standards (True Collaboration and Skilled Communication) and guided the team’s approach to a broader clinical initiative. A postintervention HWEAT survey was conducted to assess the outcomes related to the targeted standards. Concurrently, the team analyzed RRT activations and ICU transfers among patients with heart failure. Based on these findings, the team developed an early alert tool to help staff assess decompensation risk, fostering collaboration among nurses, providers, and the interprofessional team. Staff received education on tool use and safe torsemide administration, enhancing clinical decision-making and promoting a more collaborative and communicative care environment.To support long-term sustainability, the CSI team implemented strategies such as integrating education into the nurse orientation program, training nurse champions, and disseminating the initiative to other units.The CSI team at Methodist Hospital improved patient outcomes and teamwork by using HWEAT results to guide the creation and implementation of an early alert tool, staff education, and safe medication practices, resulting in fewer RRT activations and ICU transfers, as well as improved scores in True Collaboration and Skilled Communication.