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Factors associated with delayed rapid response team activation.

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Delayed rapid response team (RRT) activation is common and linked to worse patient outcomes. Factors like respiratory distress and hypotension contribute to delays, increasing mortality risk.

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Area of Science:

  • Critical Care Medicine
  • Patient Safety
  • Health Services Research

Background:

  • Delayed activation of the rapid response team (RRT) is a recognized issue in hospitals.
  • This delay is associated with adverse patient outcomes, but the contributing factors are not well understood.

Purpose of the Study:

  • To identify factors associated with delayed RRT activation.
  • To examine the impact of delayed RRT activation on patient outcomes, including mortality and length of stay.

Main Methods:

  • Observational study conducted in two Canadian hospitals between May 2012 and May 2016.
  • Included adult inpatients experiencing RRT activation, comparing those activated within 1 hour to those with delayed activation (>1 hour).
  • Primary outcome was in-hospital mortality; secondary outcomes included ICU admission and hospital length of stay.

Main Results:

  • 26.0% of 6131 patients experienced delayed RRT activation.
  • Delayed activation was more frequent on non-surgical services.
  • Reasons for RRT calls differed between groups, with respiratory distress and hypotension more common in the delayed group.
  • Delayed RRT activation was significantly associated with increased in-hospital mortality (aOR 1.23), ICU admission (aOR 1.72), and longer hospital stays.

Conclusions:

  • Delayed RRT activation is prevalent and associated with poorer patient outcomes.
  • Factors such as the clinical presentation (e.g., respiratory distress, hypotension) and the patient's service (non-surgical) influence activation delays.
  • Interventions to expedite RRT activation, particularly on non-surgical wards, may improve patient outcomes.