Impact of proactive rounding by a rapid response team on patient outcomes at an academic medical center

Background: Primary care is playing an ever increasing role in the design and implementation of new models of healthcare focused on achieving policy ends as put forth by government at both the state and federal level. The Patient Centered Medical Home (PCMH) model is a leading design in this endeavor.Objective: We sought to transform family medicine offices at an academic medical center into the PCMH model of care with improvements in patient outcomes as the end result.Results: Transformation to the PCMH model of care resulted in improved rates of control of diabetes and hypertension and improved prevention measures such as smoking cessation, mammograms, Pneumovax administration, and Tdap vaccination. Readmission rates also improved using a care coordination model.Conclusions: It is possible to transform family medicine offices at academic medical centers in methods consistent with newer models of care such as the PCMH model and to improve patient outcomes. Lessons learned along the way are useful to any practice or system seeking to undertake such transformation.

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A Controlled Trial of a Rapid Response System in an Academic Medical Center

The Joint Commission Journal on Quality and Patient Safety ◽

10.1016/s1553-7250(08)34052-5 ◽

2008 ◽

Vol 34 (7) ◽

pp. 417-425 ◽

Cited By ~ 16

Author(s):

Jeffrey M. Rothschild ◽

Seth Woolf ◽

Kathleen M. Finn ◽

Mark W. Friedberg ◽

Cindy Lemay ◽

...

Keyword(s):

Medical Center ◽

Controlled Trial ◽

Academic Medical Center ◽

Rapid Response ◽

Rapid Response System ◽

Response System ◽

Academic Medical

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Comparing Patient Outcomes of Academician-Preceptors, Hospitalist-Preceptors, and Hospitalists on Internal Medicine Services in an Academic Medical Center

Journal of General Internal Medicine ◽

10.1007/s11606-014-2982-y ◽

2014 ◽

Vol 29 (12) ◽

pp. 1672-1678 ◽

Cited By ~ 5

Author(s):

David L. Chin ◽

Michelle H. Wilson ◽

Heejung Bang ◽

Patrick S. Romano

Keyword(s):

Internal Medicine ◽

Patient Outcomes ◽

Medical Center ◽

Academic Medical Center ◽

Academic Medical

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Abstract 16125: Impact of COVID-19 on Echocardiography Volume at a Large Academic Medical Center

Circulation ◽

10.1161/circ.142.suppl_3.16125 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Merilyn S Varghese ◽

Jordan B Strom ◽

Sarah Fostello ◽

Warren J Manning

Keyword(s):

Patient Outcomes ◽

Hospital Admissions ◽

Medical Center ◽

Academic Medical Center ◽

Academic Medical ◽

Hospital Systems ◽

The Impact ◽

At Home

Introduction: COVID-19 has significantly impacted hospital systems worldwide. The impact of statewide stay-at-home mandates on echocardiography volumes is unclear. Methods: We queried our institutional echocardiography database from 6/1/2018 to 6/13/2020 to examine rates of transthoracic (TTE), stress (SE), and transesophageal echocardiograms (TEE) prior to and following the COVID-19 Massachusetts stay-at-home order on March 15, 2020. Results: Among 36,377 total studies performed during the study period, mean weekly study volume dropped from 332 + 3 TTEs/week, 30 + 1 SEs/week, and 21 + 1 TEEs/week prior to the stay-at-home order (6/1/2018-3/15/2020) to 158 + 13 TTEs/week, 8 + 2 SEs/week, and 8 + 1 TEEs/week after (% change, -52%, -73%, and -62% respectively, all p < 0.001 when comparing volume prior to March 15 versus after). Weekly TTEs correlated strongly with hospital admissions throughout the study period (r = 0.93, 95% CI 0.89-0.95, p < 0.001) ( Figure ). Outpatient TTEs declined more than inpatient TTEs (% change, -74% vs. -39%, p <0.001). As of 3 weeks following the cessation of the stay-at-home order, TTE, SE, and TEE weekly volumes have increased to 73%, 66%, and 81% of pre-pandemic levels, respectively. Conclusions: Echocardiography volumes fell precipitously following the Massachusetts stay-at-home order, strongly paralleling declines in overall hospitalizations. Outpatient TTEs declined more than inpatient TTEs. Despite lifting of the order, echocardiography volumes remain substantially below pre-pandemic levels. The impact of the decreased use of echocardiographic services on patient outcomes remains to be determined.

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Evaluating a New Rapid Response Team

AACN Advanced Critical Care ◽

10.4037/nci.0b013e318240e2f9 ◽

2012 ◽

Vol 23 (1) ◽

pp. 32-42 ◽

Cited By ~ 1

Author(s):

Kimberly Scherr ◽

Donna M. Wilson ◽

Joan Wagner ◽

Maureen Haughian

Keyword(s):

Patient Outcomes ◽

Nurse Practitioners ◽

Rapid Response Team ◽

Care Quality ◽

Rapid Response ◽

Mixed Methods Study ◽

Rapid Response Teams ◽

Response Team ◽

Paper Survey ◽

Improve Hospital

Evidence is needed to validate rapid response teams (RRTs), including those led by nurse practitioners (NPs). A descriptive-comparative mixed-methods study was undertaken to evaluate a newly implemented NP-led RRT at 2 Canadian hospitals. On the basis of data gathered on 255 patients who received an RRT call compared with the patient data for the previous year, no significant differences in the number of cardiorespiratory arrests, unplanned intensive care unit admissions, and hospital mortality were found. In addition, no significant differences in patient outcomes were identified between the NP-led and intensivist physician-led RRT calls. A paper survey revealed that ward nurses had confidence in the knowledge and skills of the NP-led RRT and believed that patient outcomes were improved as a result of their RRT call. These findings indicate that NP-led RRTs are a safe and effective alternative to intensivist-led teams, but more research is needed to demonstrate that RRTs improve hospital care quality and patient outcomes.

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Assessment of Short-Term Patient Outcomes Following Overlapping Orthopaedic Surgery at a Large Academic Medical Center

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.19.00554 ◽

2020 ◽

Vol 102 (8) ◽

pp. 654-663

Author(s):

Gregory Glauser ◽

Benjamin Osiemo ◽

Stephen Goodrich ◽

Scott D. McClintock ◽

Kristy L. Weber ◽

...

Keyword(s):

Patient Outcomes ◽

Orthopaedic Surgery ◽

Medical Center ◽

Academic Medical Center ◽

Short Term ◽

Academic Medical

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Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital

Journal of Graduate Medical Education ◽

10.4300/jgme-d-13-00165.1 ◽

2014 ◽

Vol 6 (1) ◽

pp. 61-64 ◽

Cited By ~ 5

Author(s):

Ankur Segon ◽

Shahryar Ahmad ◽

Yogita Segon ◽

Vivek Kumar ◽

Harvey Friedman ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Patient Outcomes ◽

Rapid Response Team ◽

Rapid Response ◽

Inpatient Mortality ◽

Rapid Response Teams ◽

Community Based ◽

Code Blue ◽

Response Team

Abstract Background Rapid response teams have been adopted across hospitals to reduce the rate of inpatient cardiopulmonary arrest. Yet, data are not uniform on their effectiveness across university and community settings. Objective The objective of our study was to determine the impact of rapid response teams on patient outcomes in a community teaching hospital with 24/7 resident coverage. Methods Our retrospective chart review of preintervention-postintervention data included all patients admitted between January 2004 and April 2006. Rapid response teams were initiated in March 2005. The outcomes of interest were inpatient mortality, unexpected transfer to the intensive care unit, code blue (cardiac or pulmonary arrest) per 1000 discharges, and length of stay in the intensive care unit. Results Rapid response teams were activated 213 times during the intervention period. There was no statistically significant difference in inpatient mortality (3.13% preintervention versus 2.91% postintervention), code blue calls (3.09 versus 2.89 per 1000 discharges), or unexpected transfers of patients to the intensive care unit (15.8% versus 15.5%). Conclusions The implementation of a rapid response team did not appear to affect overall mortality and code blue calls in a community-based hospital with 24/7 resident coverage.

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