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

2019 ◽  
Vol 12 (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.

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

Circulation ◽  
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.

scholarly journals Effect of a multi-faceted Rapid Response System re-design on repeat calling of the Rapid Response Team

2020 ◽  
Author(s):  
Richard Chalwin ◽  
Amy Salter ◽  
Jonathon Karnon ◽  
Victoria Eaton ◽  
Lynne Giles
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
Interrupted Time Series ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Design Phase ◽  
Rapid Response System ◽  
Multivariable Model ◽  
Response System ◽  
Response Team

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.

Rapid Response Team Organization and Activation (DRAFT)

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.

scholarly journals Clinical impact of implementing a rapid-response team based on the Modified Early Warning Score in wards that offer emergency department support

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259577
Author(s):  
Lorena Micheline Alves Silva ◽  
Diego Marques Moroço ◽  
José Paulo Pintya ◽  
Carlos Henrique Miranda
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Early Warning ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Early Warning Score ◽  
Before And After ◽  
Response Team

Background Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the modified early warning score (MEWS) in high-risk wards offering ED support is associated with decreased in-hospital mortality rate. Methods A before-and-after cross-sectional study compared in-hospital mortality rates before and after implementation of an RRT triggered by the MEWS ≥4 in two wards of a tertiary hospital that offer ED support. Results We included 6863 patients hospitalized in these wards before RRT implementation from July 2015 through June 2017 and 6944 patients hospitalized in these same wards after RRT implementation from July 2018 through June 2020. We observed a statistically significant decrease in the in-hospital mortality rate after intervention, 449 deaths/6944 hospitalizations [6.47% (95% confidence interval (CI) 5.91%– 7.07%)] compared to 534 deaths/6863 hospitalizations [7.78% (95% CI 7.17–8.44)] before intervention; with an absolute risk reduction of -1.31% (95% CI -2.20 –-0.50). Conclusion RRT trigged by the MEWS≥4 in high-risk wards that offer ED support was found to be associated with a decreased in-hospital mortality rate. A further cluster-randomized trial should evaluate the impact of this intervention in this setting.

Rapid Response System

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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