Experience of pediatric rapid response team in a tertiary care hospital in Pakistan

Area of Science:

• Pediatric critical care medicine
• Hospital quality improvement
• Patient safety initiatives

Background:

• Tertiary care hospitals in resource-constrained settings face challenges in managing pediatric emergencies.
• Pediatric rapid response teams (RRTs) are designed to provide timely critical care interventions to deteriorating patients on general wards.
• Evaluating the impact of RRT implementation is crucial for optimizing patient outcomes and resource allocation.

Purpose of the Study:

• To assess the effectiveness of a pediatric rapid response team (RRT) in a tertiary care hospital in Pakistan.
• To compare clinical outcomes and resource utilization before and after RRT implementation.
• To evaluate the impact of RRT on patient safety and mortality rates.

Main Methods:

• A retrospective audit of RRT activity was conducted over a 9-month period post-implementation.
• Patient data, including diagnoses, interventions, and outcomes, were analyzed.
• Clinical outcomes from the 9 months before RRT implementation were compared with the first 9 months after implementation.

Main Results:

• Eighty-three RRT calls were made in the 9-month post-implementation period, with respiratory issues being the most common reason.
• Early interventions by the RRT helped 61% of patients avoid unnecessary pediatric intensive care unit (PICU) stays.
• The code rate decreased from 5.2 to 2.7 per 1000 admissions, and PICU mortality decreased from 50% to 15% post-RRT implementation.

Conclusions:

• Implementation of a pediatric rapid response team (RRT) was associated with reduced cardiorespiratory arrests and mortality.
• RRTs can significantly decrease PICU resource utilization and expenditure.
• This patient safety initiative is particularly valuable in resource-constrained environments, extending critical care expertise into general pediatric wards.