Reducing hospital standardized mortality rate with early interventions.

Area of Science:

• Healthcare Management
• Patient Safety
• Critical Care Medicine

Background:

• Hospitals are implementing initiatives to reduce patient mortality.
• Rapid Response Teams (RRTs) are deployed to identify and treat deteriorating patients outside the Intensive Care Unit (ICU).
• RRTs differ from code teams by proactively intervening before a patient's arrest.

Purpose of the Study:

• To evaluate the effectiveness of a newly deployed Rapid Response Team (RRT) at Henry Ford Hospital in reducing patient mortality.
• To analyze the impact of RRT interventions on physiological deterioration outside the ICU setting.
• To assess key performance indicators related to RRT activation and patient outcomes.

Main Methods:

• Deployment of an RRT comprising ICU nurses, medical doctors, house managers, and respiratory therapists, with ICU nurses as primary responders.
• Analysis of 1,335 RRT consults and 207 medical ICU discharge follow-ups.
• Measurement of processes including "blue alerts" outside the ICU, call volume, and RRT call details (location, reason, time, outcome).

Main Results:

• Initial results indicate a reduction in "blue alerts" on general practice units.
• Respiratory triggers were the most common reason for RRT activation (low pulse oximetry, respiratory distress, abnormal respiratory rate).
• Positive evidence suggests the RRT is contributing to improved patient safety and outcomes.

Conclusions:

• The Rapid Response Team (RRT) pilot at Henry Ford Hospital shows promising results in reducing patient deterioration events.
• The RRT model, with ICU nurses as primary responders, effectively addresses physiological instability outside the ICU.
• Future implications include early sepsis recognition, family involvement, and enhanced education and practice links.