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Establishing a rapid response team (RRT) in an academic hospital: one year's experience
Emmanuel King1, Rebecca Horvath, David J Shulkin
1Department of Internal Medicine, Section of Hospital Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA. eman_310@yahoo.com
Background:
Rapid response teams and medical emergency teams have been utilized to rapidly manage seriously ill patients at risk of cardiopulmonary arrest and other high-risk conditions but have not been extensively described in the American medical literature.
Objectives:
To describe a full year's experience of implementing a rapid response team (RRT) in an academic medical center.
Design:
Retrospective analysis of our hospital's RRT database and description of the implementation process from July 2004 to July 2005.
Setting:
Urban, academic medical center.
Results:
The RRT system was activated for 307 potentially unstable patients. The most common reasons for an RRT activation were cardiac, respiratory, and neurological conditions. At least 37% of RRT calls were for off-unit inpatients and to outpatient/common areas frequented by outpatients and visitors, whereas at least 42% occurred in inpatient units. Most RRT calls, 82.9%, occurred during daytime hours. In the opinion of RRT leaders 98% of the evaluated calls were appropriate and 85% of the RRT responses resulted in the prevention of further clinical deterioration.
Conclusions:
An RRT was introduced into an academic medical center, and the results suggested it is capable of preventing clinical deterioration in unstable patients and may have the potential to decrease the frequency of cardiac arrests. The RRT also may fill a gap in patient safety by enabling rapid triage and expedited treatment of off-unit inpatients, outpatients, and visitors. The keys to the early success of our implementation of an RRT were multidisciplinary input and improvements made in real time.
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