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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Rapid response team in an academic institution: does it make a difference?

Shiwan K Shah1, Victor J Cardenas2, Yong-Fang Kuo3

  • 1Departments of Internal Medicine and Pediatrics, University of Texas Medical Branch, Galveston, TX.

Chest
|September 25, 2010
PubMed
Summary

Implementing a rapid response team (RRT) in an academic hospital did not reduce cardiac arrest rates. While overall hospital mortality saw a slight, temporary decrease, it was not attributed to the RRT.

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Area of Science:

  • Medical Outcomes Research
  • Hospital Quality Improvement
  • Critical Care Medicine

Background:

  • Rapid response systems (RRTs) are increasingly implemented in US hospitals, despite conflicting data on their effectiveness.
  • This study evaluated the impact of RRT implementation in a tertiary academic hospital setting.

Purpose of the Study:

  • To determine if the implementation of a rapid response team (RRT) improved patient outcomes at a tertiary academic hospital.
  • Specifically, to assess changes in code rates and overall hospital mortality.

Main Methods:

  • A retrospective cohort study compared 27 months post-RRT implementation with 9 months pre-implementation.
  • Data included nonobstetrics hospital admissions, patient days, code rates (cardiac/respiratory arrests), and hospital mortality.
  • The academic medical center had 24-hour in-house resident coverage.

Main Results:

  • The RRT was activated 7.7 times per 1,000 patient days.
  • No significant difference was observed in code rates between the pre- and post-RRT periods (0.83 vs 0.98 per 1,000 patient days).
  • A modest, nonsustained decrease in nonobstetrics hospital mortality was observed (2.40% vs 2.15%), not directly explained by RRT activation rates.

Conclusions:

  • RRT implementation in this academic hospital did not reduce code rates over a 27-month period.
  • The observed decrease in overall hospital mortality was small, temporary, and not attributable to the RRT's effect on code rates.
  • Further research is needed to understand the true impact of RRTs in academic medical centers.