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Organizational Perspectives on Rapid Response Team Structure, Function, and Cost: A Qualitative Study
Patricia L Smith1, Jean McSweeney
1Patricia L. Smith, PhD, RN, CCRN, is an assistant professor at the Carr College of Nursing, Harding University, in Searcy, Arkansas, where she teaches in the undergraduate nursing program. She received her doctoral from University of Arkansas for Medical Sciences. As a critical care nurse for many years, Dr Smith is passionate about improving patient safety through education and research. Jean McSweeney, PhD, RN, FAHA, FAAN, is an associate dean for research and professor at the College of Nursing, University of Arkansas for Medical Sciences, Little Rock. Dr McSweeney conducted groundbreaking research on women's cardiovascular disease. She has received numerous awards and honors throughout her career and is dedicated to developing and promoting nurse researchers.
Background:
Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs.
Objectives:
The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs.
Methods:
Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function. Face-to-face interviews were audio recorded and transcribed verbatim and verified for accurateness. Using content analysis and constant comparison, interview data were analyzed. Demographic data were analyzed using descriptive statistics.
Results:
The sample included 27 participants from 15 hospitals in 5 south-central states. They described a variety of RRT responders and functions, with the majority of hospitals having a critical care charge nurse attending all RRT calls for assistance. Others described a designated RRT nurse with primary RRT duties as responder to all RRT calls. Themes of RRT development from the data included influencers, decision processes, and thoughts about cost.
Discussion:
It is important to understand how hospitals determine optimal structure and function to enhance support of quality nursing care. Determining the impact of an RRT on costs and benefits is vital in balancing patient safety and limited resources. Future research should focus on clarifying differences between team structure and function in outcomes as well as the most effective means to estimate costs and benefits.
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