Monitor with vital signs

KATE | A Trusted Partner
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Triage nurses have extra expertise at their side with the machine learning-powered tool called KATE.

Stephen Liu, MD: Sepsis is your body's response to an infection. We get infections all the time. It could be your lungs. It could be your kidneys, your stomach, anywhere, and your body responds to it. And sepsis is when your body is starting to have a larger response to it. And then you have several degrees of sepsis. You have sepsis, severe sepsis, and septic shock. And each one, as you go up, things are getting more and more serious. Your body is throwing more and more of its resources and inflammation to try and fight the infection. And at some point, it becomes too much, and then things start to go bad. And ultimately, the thing we worry about is patients with sepsis die. Folks with severe sepsis or septic shock, mortality rate can be upwards of 30%. And so you can really progress down this pathway, and the end result is not good.

Mara Bryant: Emergency departments are always a very high-risk point. There's a lot of activity going on. People are coming in who are very sick. And you have a triage nurse in the center of all of this, needing to make decisions very quickly.

Evelyn Miguel, MSN, RN: Triage is a process where we figure out if you're a big sick or you're a little sick. And what that involves is asking you a series of questions and also taking your vital signs, which includes your blood pressure, your heart rate, your temperature, their objective symptoms that we see. So we take that information with what you're telling us, and we go ahead and we can see if maybe you are suffering from sepsis at that time. But also, we have a tool that we've had in our emergency department that is very unique to us that's called KATE.

Mara Bryant: So the KATE system and the use of the automatic intelligence is really like a person who has that triage nurse's back. And so the nurse goes through their normal triage process, puts in all the information, assigns a triage acuity level, and then KATE, within a couple of seconds, will come back with an alert to the nurse if their reading of everything she put in is a little different. And the nurse has a chance to catch her breath, look at it again and say, did I just put different data in, and it's just wrong? You know, did I type something wrong? Or is there something I didn't appreciate well enough that I should have, that maybe this patient is sicker? So really helping us protect the patients who come to our emergency department and ensure that they're getting the best care they can, no matter whether there's 100 patients in the waiting room or there's two.

Stephen Liu, MD: We've already deployed KATE in our department to look at triage because that is what KATE was built for, is to better standardize triage and more accurately triage patients. And I went back to them and said we've got this bundle that we're trying to do within one hour, so we really need to identify them the moment they walk in. Can you build a model using KATE's database of several hundreds of thousands of patients and find some patterns that help us identify sepsis earlier? And they took several months, they built a big model and found out that they could actually identify sepsis about twice as good as the best tool that we have right now, which is just two SIRS criteria and a historical source of infection.

Evelyn Miguel, MSN, RN: I think that an organization that is investing in something like KATE means that the organization is invested in the education for their staff, as well as invested into their patients.

Mara Bryant: Triage nurses are one of the highest burnout rates of any nursing position. And with KATE, our triage nurses tell us that they don't feel that stress that they used to feel. And our medical director of our emergency department, I talked with him after we implemented KATE, and he said, "You know, I don't worry about what's sitting out in my ER anymore because I know we've got it under control." And I think that is just a huge relief for everybody and a stress reducer.

Stephen Liu, MD: KATE is a great tool. She's not the answer. She's not meant to replace any triage nurses. We tell all my nurses that you are the expert. You're there. You're touching the patient. You're seeing the patient, and you have all the unknown variables that you bring to the encounter, and KATE is a tool. She's been here up and running for almost three years now. And after seeing what she's done, I think every hospital in the country should use this.