ALERT Scale Use

The MOST score is now referred to as the ALERT Scale.

eArLy-prEdiction of adveRse hospiTal outcome for medical patients

What is it and how is it used

It is an equation that provides a score for the early prediction of the probability of an adverse hospital outcome for medical patients and uses values the Regional Database program collects at patient admission.

The early stratification of medical patients for subsequent risk of an adverse outcome may have potential benefits for determining the type of care environment to which a patient should initially be admitted. (ICU, step-up unit etc.). The early risk stratification tool can compliment other assessment measures used in the initial assessment of patients admitted to general medicine wards to better screen patients who can then be provided more effective care.

Adverse outcomes

• within 30 days of hospitalization:
  • cardiac arrest
  • death
• within first 48 hours
  • transferred to ICU from a ward

Exclusions

• palliative care clients
  • patients whose first ward admission had an Admit Diagnosis or Comorbid Diagnosis diagnosis of Palliative Service (would be Palliative care now)
• patients with unknown outcomes
  • discharged to non medicine service (e.g. Ward, ICU, OR, etc.) in the hospital and are unable to be tracked in the database.

History and Development

The MOST score (ALERT Scale) was validated on data collected at HSC, SBGH, the Grace and Victoria hospital on over 11,000 patients admitted to medical units in 2004/2005.

• ALERT Scale is based on the FIRST ward admission during a hospital stay.
• There is no existing tool that can make such prediction for non ICU patients. This makes this equation and the research conducted by Dr. Roberts and Julie Mojica with the support of the data collection team extremely valuable.