PURPOSE: The Rothman Index (RI) is an acuity metric that incorporates 26 variables of physiological measures, clinical assessments and laboratory results into a composite index that is trended over time. If the RI drops more than 30% in <6 hours, 50% in <24 hours or an absolute value <20 in the previous 24 hours, a warning sign graded as medium, high or very high risk respectively, alerts the clinician. As part of a quality improvement project, our objectives were- 1. Determine if RI could predict adverse events occurring within 72 hours of medical intensive care unit (MICU) discharge decision 2. Find a cut point for the RI that can predict adverse events 3. Determine if there is a relation between warning sign 24 hours prior to discharge and adverse events post-discharge.