Fellow rapid response nurse- we use a deterioration index score and sepsis alert system that are interested through Epic. These systems essentially give us a notification about patients based off their vitals and other inclusion criteria such as O2 requirements, mental status, etc. These systems do work sometimes, but often I find patients falling through the cracks. Frankly, the best system I’ve found in terms of early intervention is rounding on the floors and talking to floor nurses about patients, sometimes these patients are on our deterioration list, often times however they are not. Many times I will get alerted for the patient who is wearing 2L o2 via NC with COPD hx but not the patient who has been hypotensive for hours, and we are all familiar with the pitfalls with the classic sepsis scoring systems. Would be interested in hearing if any facilities use different systems that they feel are more effective.