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Reduction in Mortality Following Pediatric Rapid Response Team Implementation
Nikoleta S Kolovos1, Jeff Gill2,3,4, Peter H Michelson1
1Department of Pediatric, Washington University in St. Louis, St. Louis, MO.
Objective:
To evaluate the effectiveness of a physician-led rapid response team program on morbidity and mortality following unplanned admission to the PICU.
Design:
Before-after study.
Setting:
Single-center quaternary-referral PICU.
Patients:
All unplanned PICU admissions from the ward from 2005 to 2011.
Interventions:
The dataset was divided into pre- and post-rapid response team groups for comparison.
Measurements And Main Results:
A Cox proportional hazards model was used to identify the patient characteristics associated with mortality following unplanned PICU admission. Following rapid response team implementation, Pediatric Risk of Mortality, version 3, illness severity was reduced (28.7%), PICU length of stay was less (19.0%), and mortality declined (22%). Relative risk of death following unplanned admission to the PICU after rapid response team implementation was 0.685.
Conclusions:
For children requiring unplanned admission to the PICU, rapid response team implementation is associated with reduced mortality, admission severity of illness, and length of stay. Rapid response team implementation led to more proximal capture and aggressive intervention in the trajectory of a decompensating pediatric ward patient.
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