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Evaluating implementation of a rapid response team: considering alternative outcome measures
James P Moriarty1, Nicola E Schiebel, Matthew G Johnson
1Health Care Policy and Research, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. naessens@mayo.edu.
Summary
Rapid Response Team (RRT) implementation reduced failure to rescue (FTR) rates, particularly after a sufficient number of RRT calls were made. Long-term monitoring is crucial for assessing RRT impact on patient outcomes.
Area of Science:
- Healthcare Management
- Patient Safety
- Clinical Operations
Background:
- Failure to rescue (FTR) is a critical indicator of hospital quality.
- Rapid Response Teams (RRTs) are designed to improve patient outcomes by intervening early.
- The prolonged impact of RRT implementation on FTR requires further investigation.
Purpose of the Study:
- To determine the sustained effect of RRT implementation on the rate of failure to rescue.
- To analyze the relationship between RRT utilization and FTR over time.
Main Methods:
- A longitudinal study analyzing institutional performance data from two academic hospitals.
- Utilized control charts and Bayesian change point (BCP) analysis to assess trends.
- Examined data from inpatients discharged between September 2005 and December 2010.
Main Results:
- A decrease in FTR and an increase in unplanned ICU transfers were observed in the second year post-RRT implementation.
- No significant pre- vs. post-implementation decreases were found for cardiopulmonary resuscitation events or overall mortality.
- Control charts indicated a significant decrease in mortality for non-ICU discharges, a finding not supported by BCP analysis.
Conclusions:
- FTR rate reduction correlated with increased RRT calls, suggesting a threshold effect for RRT impact.
- FTR may be a more sensitive measure of RRT effectiveness than cardiac arrest rates.
- Short-term studies may underestimate RRT system impact; ongoing outcome monitoring is essential for resource optimization.
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