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.

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.

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.

Evolution and Evidence for Rapid Response Teams (DRAFT)

2018 ◽  
Author(s):  
Muhammad Tahseen ◽  
Richard L. Simmons
Keyword(s):  
Rapid Response Team ◽  
Healthcare Facility ◽  
Rapid Response ◽  
Rapid Response Teams ◽  
Healthcare Organizations ◽  
Response Team ◽  
National Patient ◽  
Recognition And Response ◽  
Meta Analyses ◽  
The Impact

A rapid response system (RRS) is a program designed to respond in a timely, organized, and comprehensive manner to a patient’s urgent unmet medical need within a healthcare facility. The goals of the rapid response team (RRT) are to restore homeostasis, prevent further physiologic deterioration, and establish an optimal environment of care. RRTs are now in widespread use in the US because of the Joint Commission’s national patient safety goals, which required that healthcare organizations improve recognition and response to changes in a patient’s condition. Recent meta-analyses have now concluded that RRT is effective in reducing the incidence of cardiac arrests within hospitals. There is still controversy, however, on the impact of RRT on ultimate clinical outcomes, including mortality. In this chapter, we review the history and evolution of RRTs, rationale for its existence, its impact on patient outcomes, and current controversies.

The implementation of a rapid response team at Memorial Sloan-Kettering Cancer Center: A preliminary report

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6627-6627
Author(s):  
A. D. Klotz ◽  
E. Thattassery ◽  
D. Graham
Keyword(s):  
Hospital Mortality ◽  
Cancer Patients ◽  
Statistical Significance ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Cancer Center ◽  
Response Team ◽  
Alternate Level Of Care ◽  
The Impact ◽  
Safety Initiative

6627 Background: The implementation of a rapid response team (RRT) has become a popular patient safety initiative at many health care institutions during the past decade. To date, there are no studies evaluating the utilization or impact of a rapid response team in a population of cancer patients. We report on our experience implementing such a team at Memorial Sloan-Kettering Cancer Center. Methods: A consecutive cohort of all consults performed by the RRT between July 1st and December 31th, 2006 had the following variables recorded: primary cancer diagnosis, reason for consult, RRT intervention. Outcomes measured were survival to discharge and 30 day survival. Hospital mortality and hospital codes were compared to historical data from 2005 and were adjusted for hospital census. Results: There were 195 consults requested between July 1st and December 31st, 2006. The majority of these patients were on the medical service (124 vs 66 on surgical service). The most common primary malignancies for which the RRT was called arose from the gastrointestinal tract (30.2%), thoracic cavity (12.8%), urologic tract (9.3%), and breast (7.6%). Most consults were requested for compromised respiratory function (n=76), cardiovascular (n=72, 34 hypotension, 23 tachycardia), and neurologic derangements (n=13). 33 patients (16.9%) required transfer to an alternate level of care such as telemetry or the intensive care unit. 121 patients (65%) seen by the RRT survived to discharge however 92 (47%) died within 30 days of an RRT consult. Hospital codes decreased 21% (55 vs 70, p<0.10) and hospital mortality decreased 22% (3.43 deaths per 1,000 discharges vs 4.43 deaths per 1,000 discharges) following implementation of the RRT although these results did not achieve statistical significance. Conclusions: The Rapid Response Team at MSKCC assists in the acute management of hospitalized cancer patients. Many of these patients are critically-ill and are near the end of their oncologic course. Further studies are necessary to better characterize the impact of this resource and determine how it can be utilized most effectively. No significant financial relationships to disclose.

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.

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

2015 ◽  
Vol 10 (6) ◽  
pp. 352-357 ◽  
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

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.

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.

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.

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