Timing and teamwork—An observational pilot study of patients referred to a Rapid Response Team with the aim of identifying factors amenable to re-design of a Rapid Response System

ABSTRACTBackgroundRepeat Rapid Response Team (RRT) calls are associated with increased mortality risk to patients and pose a resource burden to organisations. Use of Non-Technical Skills (NTS) at calls has the potential to reduce potentially preventable repeat calling. NTS are usually improved through training, however this consumes time and financial resources. Modifications to the Rapid Response System (RRS) that promote use of NTS are worth exploring as a cost-effective alternative.MethodsA pre-post observational study of a RRS re-design on proportion of admissions each month subject to repeat RRT calling and number of calls per admission, with univariate and multivariable interrupted time series analyses comparing outcomes between study phases.ResultsThe proportion of admissions with repeat calls each month increased across both phases of the study period, but the increase was lower in the post re-design phase (change in adjusted regression slope -0.12 (standard error 0.07) post versus pre re-design). The multivariable model showed an estimated 6.0% reduction (P=0.19) in the proportion of admissions having repeat calls at the end of the study versus that predicted had the re-design not occurred.For the number of calls per the multivariable model predicted a reduction of 0.07 calls per admission at the end of the post re-design phase (95% confidence interval -0.23 – 0.08, P=0.35), equating to one fewer repeat call per 14 patients having RRT calls.ConclusionThis study showed no observed statistically significant effect on rates of repeat calling or numbers of repeat calls per admission from the implementation of a RRS re-design. However, the results demonstrate, at an organisational level, the feasibility of a low-cost initiative to improve NTS use by the RRS.

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4 - Rapid response team nurses’ beliefs and attitudes to the rapid response system: a multicentre survey

10.26226/morressier.5b51cf46b1b87b0009beb8d1 ◽

2018 ◽

Author(s):

Joonas Tirkkonen

Keyword(s):

Rapid Response Team ◽

Rapid Response ◽

Rapid Response System ◽

Response System ◽

System A ◽

Response Team ◽

Beliefs And Attitudes

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Outcomes of rapid response team implementation in tertiary private hospitals: a prospective cohort study

International Journal of Emergency Medicine ◽

10.1186/s12245-019-0248-5 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Awad Al-Omari ◽

Abbas Al Mutair ◽

Fadi Aljamaan

Keyword(s):

Mortality Rate ◽

Hospital Mortality ◽

Cardiopulmonary Arrest ◽

Rapid Response Team ◽

Rapid Response ◽

Dramatic Reduction ◽

Rapid Response System ◽

Private Hospitals ◽

Response System ◽

Response Team

Abstract Background Cardiopulmonary arrest may result in high mortality rate in hospitals where the rapid response team is not implemented. A rapid response system can recognize patients at high risk of cardiopulmonary arrest and provide the needed medical management to prevent further deterioration. The rapid response system has shown a dramatic reduction in mortality rate and cardiopulmonary arrest. Objective To evaluate the effectiveness of the rapid response team (RRT) implementation in reducing the mortality rate, number of cardiopulmonary arrests, and number of ICU admission. Design A pre- and post-rapid response team system implementation. Setting Four tertiary private hospitals in Saudi Arabia. Patients A total of 154,869 patients in the 3-year before rapid response system period (January 2010 to December 2012) and a total of 466,161 during the 2.5-year post-RRT implementation period (January 2014 to June 2016). Results Results indicated that ward nurses activated RRT more often than physicians (1104 activations [69%] vs. 499 activations [31%]), with cardiovascular and respiratory abnormalities being the most common triggers. Serious concern about the patient condition by the ward staff was the trigger for 181 (11.29%) activations. The RRT provided a variety of diagnostic and therapeutic interventions. Most patients cared for by RRT were admitted to ICU 1103 (68.81%), and the rest 500 (31.19%) were managed in the ward. After the implementation of the RRT project, the hospital mortality rate dropped from 7.8 to 2.8 per 1000 hospital admission. Hospital cardiopulmonary arrest rate has dropped from 10.53 per 1000 hospital admissions to 2.58. Rapid response team implementation also facilitated end-of-life care discussions. Conclusion Implementation of the RRT project has shown a dramatic reduction in the total ICU admissions, average ICU occupancy rate, total hospital mortality, and total ICU mortality. These findings reinforce the evidence that RRT implementation is effective in reducing hospital mortality and cardiopulmonary arrest rates in addition to other outcomes related to healthcare quality.

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Rapid response team nurses’ beliefs and attitudes to the rapid response system: A multicentre survey

Resuscitation ◽

10.1016/j.resuscitation.2018.07.278 ◽

2018 ◽

Vol 130 ◽

pp. e130

Author(s):

Joonas Tirkkonen ◽

Eetu Loisa ◽

Sanna Hoppu

Keyword(s):

Rapid Response Team ◽

Rapid Response ◽

Rapid Response System ◽

Response System ◽

System A ◽

Response Team ◽

Beliefs And Attitudes

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Implementation of critical care staff based rapid response team. effect of rapid response system to the unpredicted death

Intensive Care Medicine Experimental ◽

10.1186/2197-425x-3-s1-a67 ◽

2015 ◽

Vol 3 (S1) ◽

Author(s):

M Arai ◽

T Koike ◽

M Moriyasu ◽

S Ito ◽

T Ootsuka ◽

...

Keyword(s):

Critical Care ◽

Rapid Response Team ◽

Rapid Response ◽

Care Staff ◽

Rapid Response System ◽

Response System ◽

Response Team

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Rapid Response Team Organization and Activation (DRAFT)

10.1093/med/9780190612474.003.0002 ◽

2018 ◽

Author(s):

Carol Curio Scholle

Keyword(s):

Administrative Support ◽

Rapid Response Team ◽

Rapid Response ◽

Allocation Of Resources ◽

Rapid Response System ◽

Response System ◽

Response Team ◽

Team Organization ◽

Physical Layout

The Rapid Response System (RRS) is organized into four basic components. These components include an activation limb, a response limb, a quality assurance infrastructure, and an administrative component. These components remain consistent despite campus size, physical layout, patient population, available technical resources, and personnel. Oversight of the RRS is provided by the patient safety, risk management experts, as well as clinical experts to maintain high quality of care delivered to acutely ill patients. Administrative support in the development of policy, allocation of resources, and communicating a strong and clear message regarding the mission and vision of the RRS is invaluable. In this chapter, we review each element of the RRS.

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Rapid Response System

10.1093/med/9780190612474.001.0001 ◽

2018 ◽

Author(s):

John A. Kellum

Keyword(s):

Patient Safety ◽

Rapid Response Team ◽

Rapid Response ◽

Rapid Response System ◽

Team Members ◽

Emergency Procedures ◽

Response System ◽

Response Team ◽

Behavioral Emergencies ◽

Organization Leadership

This handbook provides a practical approach to the evaluation, differential diagnosis, and management of common medical and surgical emergencies such as cardiac arrest, acute respiratory failure, seizures, and hemorrhagic shock occurring in hospitalized patients. Less common and special circumstances such as pediatric, obstetric, oncologic, neurologic, and behavioral emergencies as well as palliative care for terminally ill patients encountered in the context of rapid response team (RRT) events are also discussed. An overview of commonly performed bedside emergency procedures by rapid response team members complements the clinical resources that may need to be brought to bear during the course of the rapid response team event. Finally, an overview of organization, leadership, communication, quality, and patient safety surrounding rapid response team events is provided. This book is written with medical students, junior physicians, and nursing staff in mind working in both academic and community hospital settings. Both a novice and an experienced healthcare provider involved in a rapid response system (RRS) will find this handbook to be a valuable supplement to the clinical experiences gained through active engagement in the system. Hospital administrators and senior management staff will also find this book to be useful in the evaluation of quality and performance of the rapid response system, management of staff attitudes and behavior, performance of peer review, care for second victims, and implementation of countermeasures for patient safety problems discovered in the course of rapid response system reviews.

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