Delayed Rapid Response Team Activation Is Associated With Increased Hospital Mortality, Morbidity, and Length of Stay in a Tertiary Care Institution

Purpose: We sought to evaluate if incorporating an early warning system (EWS), the Visensia Safety Index (VSI) and the National Early Warning Systems 2 (NEWS2), may lead to earlier identification of rapid response team (RRT) patients. Methods: This was a retrospective study (2015-2018) of patients experiencing RRT activation within a tertiary care network. We evaluated the proportion of patients with an EWS alert prior to RRT activation and their associated outcomes (primary: hospital mortality). Results: There were 6,346 RRT activations over the study period. Of these, 2042 (50.8%) patients would have had a VSI alert prior to RRT activation, with a median advanced time of 3.6 (IQR 0.5-12.8) hours, compared to 2351 (58.4%) patients and 9.8 (IQR 2.0-18.7) hours for NEWS2. Patients with a potential alert prior to RRT activation had an increased odds of mortality for both VSI (OR 1.2, 95%CI 1.1-1.3) and NEWS2 (OR 2.7, 95% CI 2.4-3.1). Prognostic accuracy for hospital mortality was similar between groups. Conclusion: Utilization of an EWS by an RRT has potential to provide earlier recognition of deterioration and mortality risk among hospitalized inpatients.

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A novel configuration of a traditional rapid response team decreases non-intensive care unit arrests and overall hospital mortality

Journal of Hospital Medicine ◽

10.1002/jhm.2338 ◽

2015 ◽

Vol 10 (6) ◽

pp. 352-357 ◽

Cited By ~ 10

Author(s):

Daniel P. Davis ◽

Steve A. Aguilar ◽

Patricia G. Graham ◽

Brenna Lawrence ◽

Rebecca E. Sell ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hospital Mortality ◽

Rapid Response Team ◽

Rapid Response ◽

Response Team

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Abstract 288: Rapid Response Team Implementation Associated with Reductions in In-hospital Mortality Rate and Hospitalization Costs: A Retrospective Analysis

Circulation ◽

10.1161/circ.142.suppl_4.288 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Jacob Sessim Filho ◽

Renato P Azevedo ◽

Antonildes N Assuncao ◽

Marcia M Sa ◽

Felipe D Silva ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Mortality ◽

Statistical Power ◽

Early Recognition ◽

Rapid Response Team ◽

Rapid Response ◽

Clinical Deterioration ◽

Medical Database ◽

Hospitalization Costs ◽

Response Team

Introduction: Early recognition of clinical deterioration in inpatient subjects seems to be one of the main factors associated with prevention of in-hospital severe adverse events occurrence. Previous studies failed to demonstrate that the implementation of a rapid response team (RRT) could reduce in-hospital mortality rate. Hypothesis: Could a RRT implementation reduces in-hospital mortality and/or hospitalizations costs in a private general hospital in Brazil? Methods: This is a retrospective cohort built from data of electronic medical database of consecutive adult inpatients admitted to general wards who had to be transferred to an ICU after an acute clinical deterioration between May 1st, 2012 and June 30th, 2016. Subjects were divided into two groups as follows: group 1 (G1) with those admitted to ICU before RRT implementation on June 1st, 2014 and group 2 (G2) with the ones admitted to ICU after the implementation. All patients in G2 received care by the RRT before ICU admittance. In cases in which a patient had more than one hospital admission, only the first admittance was used for analyses. Results: Patients data are shown in table 1.Outcome data are shown in table 2. Conclusions: From these data, it is possible to infer that this RRT implementation at this hospital was associated with improvement in clinical outcomes of inpatients who needed an ICU admittance after an acute clinical deterioration, as well as a significant reduction of their hospitalization costs. These data reinforce the hypotheses that MERIT study was underpowered. Further multicenter randomized trials, with appropriate statistical power, shall be proposed to address these questions.

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Reduced frequency of cardiopulmonary arrests by rapid response teams

Einstein (São Paulo) ◽

10.1590/s1679-45082012000400009 ◽

2012 ◽

Vol 10 (4) ◽

pp. 442-448 ◽

Cited By ~ 3

Author(s):

Paulo David Scatena Gonçales ◽

Joyce Assis Polessi ◽

Lital Moro Bass ◽

Gisele de Paula Dias Santos ◽

Paula Kiyomi Onaga Yokota ◽

...

Keyword(s):

Hospital Mortality ◽

Rapid Response Team ◽

Rapid Response ◽

High Complexity ◽

Rapid Response Teams ◽

Cardiorespiratory Arrest ◽

Reduced Frequency ◽

Before And After ◽

Response Team ◽

The Impact

OBJECTIVE: To evaluate the impact of the implementation of a rapid response team on the rate of cardiorespiratory arrests in mortality associated with cardiorespiratory arrests and on in-hospital mortality in a high complexity general hospital. METHODS: A retrospective analysis of cardiorespiratory arrests and in-hospital mortality events before and after implementation of a rapid response team. The period analyzed covered 19 months before intervention by the team (August 2005 to February 2007) and 19 months after the intervention (March 2007 to September 2008). RESULTS: During the pre-intervention period, 3.54 events of cardiorespiratory arrest/1,000 discharges and 16.27 deaths/1,000 discharges were noted. After the intervention, there was a reduction in the number of cardiorespiratory arrests and in the rate of in-hospital mortality; respectively, 1.69 events of cardiorespiratory arrest/1,000 discharges (p<0.001) and 14.34 deaths/1,000 discharges (p=0.029). CONCLUSION: The implementation of the rapid response team may have caused a significant reduction in the number of cardiorespiratory arrests. It was estimated that during the period from March 2007 to September 2008, the intervention probably saved 67 lives.

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Implementation of a Formal Debriefing Program After Pediatric Rapid Response Team Activations

Journal of Graduate Medical Education ◽

10.4300/jgme-d-17-00511.1 ◽

2018 ◽

Vol 10 (2) ◽

pp. 203-208 ◽

Cited By ~ 5

Author(s):

Linda Aponte-Patel ◽

Arash Salavitabar ◽

Pamela Fazzio ◽

Andrew S. Geneslaw ◽

Pamela Good ◽

...

Keyword(s):

Intensive Care ◽

Real Time ◽

Health Professionals ◽

Tertiary Care ◽

Rapid Response Team ◽

Rapid Response ◽

Staff Attitudes ◽

Learning Opportunity ◽

Respiratory Therapists ◽

Response Team

ABSTRACT Background Debriefing after pediatric rapid response team activations (RRT-As) in a tertiary care children's hospital was identified to occur only sporadically. The lack of routine debriefing after RRT-As was identified as a missed learning opportunity. Objective We implemented a formal debriefing program and assessed staff attitudes toward and experiences with debriefing after pediatric RRT-As. Methods Real-time feedback for pediatrics residents captured clinical and debriefing data for each RRT-A from July 2014 to June 2016. The debriefing on physiology, team communication, and anticipation of clinical deterioration was introduced in July 2015. To assess debriefing perceptions, residents, intensive care fellows, nurses, and respiratory therapists participated in anonymous preintervention and postintervention surveys. We also developed a workshop to teach residents how to lead debriefing. Results Debriefing after RRT-As increased from 26% preintervention to 46% postintervention (P < .0001). A total of 43 of 76 pediatrics residents (57%) attended at least 1 of 4 debriefing workshops. Both preintervention and postintervention, more than 80% (70 of 78 preintervention and 54 of 65 postintervention) of health professionals surveyed strongly agreed or agreed that there was a benefit to debriefing after RRT-As. Postintervention, 65% (26 of 40) of respondents strongly agreed or agreed that debriefing improved their understanding of the RRT-A process. The rate of debriefing was sustained at 46% (6 months after the end of the study period). Conclusions Debriefing frequency after pediatric RRT-As significantly increased with the introduction of a formal debriefing program. A majority of health professionals and trainees reported this practice was a valuable experience.

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