A Qualitative Analysis of Observed Behavior of Pediatric Rapid Response Team Performance

2021 ◽  
Author(s):  
Amanda B. Levin ◽  
Alexander M. Cartron ◽  
Ashley Siems ◽  
Katherine Patterson Kelly
Keyword(s):  
Team Performance ◽  
Qualitative Data ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Response Team ◽  
Enhance Patient Safety ◽  
Field Notes ◽  
Conventional Content Analysis

BACKGROUND AND OBJECTIVES Pediatric rapid response teams (RRTs) enhance patient safety, reduce cardiorespiratory arrests outside the PICU, and detect deteriorating patients before decompensation. RRT performance may be affected by failures in communication, poor team dynamics, and poor shared decision-making. We aimed to describe factors associated with team performance using direct observation of pediatric RRTs. METHODS Our team directly observed 73 in situ RRT activations, collected field notes of qualitative data, and analyzed the data using conventional content analysis. To assess accuracy of coding, 20% of the coded observations were reassessed for interrater reliability. The codes influencing team performance were categorized as enhancers or threats to RRT teamwork and organized under themes. We constructed a framework of the codes and themes, organized along a spectrum of orderly versus chaotic RRTs. RESULTS Three themes influencing RRT performance were teamwork, leadership, and patient and family factors, with underlying codes that enhanced or threatened RRT performance. Novel factors that were found to threaten team performance included indecision, disruptive behavior, changing leadership, and family or patient distress. Our framework delineating features of orderly and chaotic RRTs may be used to inform training and design of RRTs to optimize performance. CONCLUSIONS Observations of in situ RRT activations in a pediatric hospital both verified previously described characteristics of RRTs and identified new characteristics of team function. Our proposed framework for understanding these enhancers and threats may be used to inform future interventions to improve RRT performance.

Rapid Response Teams: Qualitative Analysis of Their Effectiveness

2013 ◽  
Vol 22 (3) ◽  
pp. 198-210 ◽  
Author(s):  
Linda Searle Leach ◽  
Ann M. Mayo
Keyword(s):  
Time Pressure ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Multiple Perspectives ◽  
Rapid Response Teams ◽  
Effective Response ◽  
Team Members ◽  
Grounded Theory Method ◽  
Response Team ◽  
Patients At Risk

Background Multidisciplinary rapid response teams focus on patients’ emergent needs and manage critical situations to prevent avoidable deaths. Although research has focused primarily on outcomes, studies of the actual team effectiveness within the teams from multiple perspectives have been limited. Objective To describe effectiveness of rapid response teams in a large teaching hospital in California that had been using such teams for 5 years. Methods The grounded-theory method was used to discover if substantive theory might emerge from interview and/or observational data. Purposeful sampling was used to conduct in-person semistructured interviews with 17 key informants. Convenience sampling was used for the 9 observed events that involved a rapid response team. Analysis involved use of a concept or indicator model to generate empirical results from the data. Data were coded, compared, and contrasted, and, when appropriate, relationships between concepts were formed. Results Dimensions of effective team performance included the concepts of organizational culture, team structure, expertise, communication, and teamwork. Conclusions Professionals involved reported that rapid response teams functioned well in managing patients at risk or in crisis; however, unique challenges were identified. Teams were loosely coupled because of the inconsistency of team members from day to day. Team members had little opportunity to develop relationships or team skills. The need for team training may be greater than that among teams that work together regularly under less time pressure to perform. Communication between team members and managing a crisis were critical aspects of an effective response team.

Pharmacists as Members of the Rapid Response Team

2014 ◽  
Vol 29 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Christine M. Groth ◽  
Nicole M. Acquisto
Keyword(s):  
Chart Review ◽  
Cardiopulmonary Arrest ◽  
Rapid Response Team ◽  
Medication Administration ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Early Therapy ◽  
Patient Demographics ◽  
Time Commitment ◽  
Response Team

Purpose: Rapid response teams (RRTs) have been developed to provide early therapy to patients with risk factors for cardiopulmonary arrest. We sought to investigate the role a pharmacist could have as a member of the RRT. Methods: Two pharmacists trained in critical care and emergency medicine proposed a pilot program to determine whether a pharmacist as a member of the RRT could help to optimize pharmacotherapy and facilitate medication administration. During response, 1 pharmacist was at the bedside with the RRT for patient evaluation, consult, chart review, and to facilitate medication administration. The responding RRT pharmacist collected patient demographics, medications administered, pharmacotherapy recommendations, and time commitment. Results: The pharmacists responded to 32 RRT alerts. A majority (65.6%) of patients required at least 1 medication, and a total of 45 medications were administered. The pharmacists performed 49 pharmacotherapy-related interventions in 21 patients. These included medication facilitation (15), dose (15) or therapy (8) recommendations, and adding (6) or discontinuing (5) a medication. The pharmacists spent a median time of 15 minutes (interquartile range [IQR] 15, range 2-70) for each RRT alert and a total of 612 minutes (10.2 hours). Conclusion: With a minimal time commitment, pharmacists can be valuable members of the RRT.

Evaluating a New Rapid Response Team

2012 ◽  
Vol 23 (1) ◽  
pp. 32-42 ◽  
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.

scholarly journals Reduced frequency of cardiopulmonary arrests by rapid response teams

2012 ◽  
Vol 10 (4) ◽  
pp. 442-448 ◽  
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.

Observing rapid response team performance to improve outcomes

2020 ◽  
Vol 33 ◽  
pp. S23
Author(s):  
Emma Wood ◽  
Adam Coleman ◽  
Rosemary Saunders
Keyword(s):  
Team Performance ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Response Team

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

2014 ◽  
Vol 6 (1) ◽  
pp. 61-64 ◽  
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.

Addition of Acute Care Nurse Practitioners to Medical and Surgical Rapid Response Teams: A Pilot Project

2014 ◽  
Vol 34 (1) ◽  
pp. 51-59 ◽  
Author(s):  
April N. Kapu ◽  
Arthur P. Wheeler ◽  
Byron Lee
Keyword(s):  
Acute Care ◽  
Nurse Practitioners ◽  
Rapid Response Team ◽  
Pilot Project ◽  
Rapid Response ◽  
Therapeutic Interventions ◽  
Rapid Response Teams ◽  
Care Nurse ◽  
Response Team ◽  
The Impact

BackgroundVanderbilt University Hospital’s original rapid response team included a critical care charge nurse and a respiratory therapist. A frequently identified barrier to care was the time delay between arrival of the rapid response team and arrival of the primary health care team.ObjectiveTo assess the impact of adding an acute care nurse practitioner to the rapid response team.MethodsAcute care nurse practitioners were added to surgical and medical rapid response teams in January 2011 to diagnose and order treatments on rapid response calls.ResultsIn 2011, the new teams responded to 898 calls, averaging 31.8 minutes per call. The most frequent diagnoses were respiratory distress (18%), postoperative pain (13%), hypotension (12%), and tachyarrhythmia (10%). The teams facilitated 360 transfers to intensive care and provided 3056 diagnostic and therapeutic interventions. Communication with the primary team was documented on 97% of the calls. Opportunities for process improvement were identified on 18% of the calls. After implementation, charge nurses were surveyed, with 96% expressing high satisfaction associated with enhanced service and quality.ConclusionsTeams led by nurse practitioners provide diagnostic expertise and treatment, facilitation of transfers, team communication, and education.

Rapid Response Teams: Is it Time to Reframe the Questions of Rapid Response Team Measurement?

2016 ◽  
Vol 48 (6) ◽  
pp. 616-623 ◽  
Author(s):  
Gail G. Salvatierra ◽  
Ruth C. Bindler ◽  
Kenn B. Daratha
Keyword(s):  
Rapid Response Team ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Response Team

scholarly journals Trends and Characteristics of CDC Global Rapid Response Team Deployments—A 6-Month Report, October 2018–March 2019

2020 ◽  
Vol 135 (3) ◽  
pp. 310-312
Author(s):  
Amen Ben Hamida ◽  
Dante Bugli ◽  
Adela Hoffman ◽  
Ashley L. Greiner ◽  
Danny Harley ◽  
...  
Keyword(s):  
Rapid Response Team ◽  
Lessons Learned ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Health Security ◽  
Staff Members ◽  
Future Needs ◽  
Response Team ◽  
Control And Prevention ◽  
Almost All

The Centers for Disease Control and Prevention (CDC) Global Rapid Response Team (GRRT) was launched in June 2015 to strengthen the capacity for international response and to provide an agency-wide roster of qualified surge-staff members who can deploy on short notice and for long durations. To assess GRRT performance and inform future needs for CDC and partners using rapid response teams, we analyzed trends and characteristics of GRRT responses and responders, for deployments of at least 1 day during October 1, 2018, through March 31, 2019. One hundred twenty deployments occurred during the study period, corresponding to 2645 person-days. The median deployment duration was 19 days (interquartile range, 5-30 days). Most deployments were related to emergency response (n = 2367 person-days, 90%); outbreaks of disease accounted for almost all deployment time (n = 2419 person-days, 99%). Most deployments were to Africa (n = 1417 person-days, 54%), and epidemiologists were the most commonly deployed technical advisors (n = 1217 person-days, 46%). This case study provides useful information for assessing program performance, prioritizing resource allocation, informing future needs, and sharing lessons learned with other programs managing rapid response teams. GRRT has an important role in advancing the global health security agenda and should continuously be assessed and adjusted to new needs.

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