Rapid response team trigger modifications: are we using them safely?

Area of Science:

• Medical Safety
• Healthcare Quality Improvement
• Clinical Operations

Background:

• Rapid response teams (RRTs) aim to reduce inpatient morbidity and mortality.
• Modifying RRT activation triggers may risk delayed recognition of patient deterioration.
• The safety of RRT trigger modifications has not been previously validated.

Purpose of the Study:

• To assess the association between RRT trigger modifications and recurrent RRT activations.
• To determine the impact of RRT trigger modifications on length of stay (LOS).
• To evaluate the relationship between RRT trigger modifications and in-hospital mortality.

Main Methods:

• A retrospective audit of RRT activations was conducted at Launceston General Hospital.
• The study period spanned 18 months.
• Data on RRT activations, LOS, intensive care admissions, and mortality were analyzed.

Main Results:

• Trigger modifications did not decrease recurrent RRT activations; frequency increased with two modifications.
• Hospital LOS significantly increased for patients with any or multiple trigger modifications.
• In-hospital mortality risk rose with an increasing number of trigger modifications.

Conclusions:

• RRT trigger modifications are linked to increased hospital LOS and mortality.
• Modifications do not reduce recurrent RRT events.
• Multiple trigger modifications may facilitate goals-of-care discussions for non-escalation patients.