Rapid response team implementation on a burn surgery/acute care ward.

Area of Science:

• Medical Outcomes Research
• Hospital Quality Improvement
• Patient Safety

Background:

• Limited evidence exists for the efficacy of rapid response teams (RRTs) in burn care despite widespread hospital implementation.
• The burn surgery/acute care ward at Harborview Medical Center treats diverse patient populations, including burns, wounds, trauma, and overflow surgical/medical cases.

Purpose of the Study:

• To investigate the impact of institutional RRT implementation in 2006 on code blue activations, unplanned intensive care unit (ICU) transfers, and mortality.
• To analyze clinical signs triggering RRT activation and post-activation care processes.

Main Methods:

• Retrospective analysis of patients treated in the acute care unit before (2000-2004) and after (2007-2011) RRT implementation.
• Comparison of code blue activation rates, unplanned ICU transfers, and mortality using Poisson regression, adjusted for case-mix index, age, and medical service.

Main Results:

• RRT implementation was associated with a significant decrease in code blue calls (1.4 to 0.4/1000 admissions) and unplanned ICU transfers (65 to 50/1000 admissions).
• A trend toward reduced hospital deaths was observed (4.5 to 3.3/1000 admissions), with a notable decrease in mortality among burn and surgical patients.
• Respiratory symptoms like stridor and tachypnea, along with low oxygen saturation, were identified as indicators for RRT patients who did not survive.

Conclusions:

• RRT implementation at this academic medical center was linked to improved patient safety outcomes, including reduced critical events and a potential decrease in mortality.
• The findings support the effectiveness of RRTs in managing acute care ward patients, particularly in reducing adverse events and improving survival for vulnerable populations like burn and surgical patients.