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Related Experiment Video

Updated: Sep 13, 2025

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

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Published on: August 5, 2020

Rapid Response Events Prompt Increased Goals of Care Discussions and Code Status Changes.

Joelle N Friesen¹, Erik J Wanberg², Alexandra Allman¹

¹Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

The American Journal of Hospice & Palliative Care

|July 29, 2025

Summary

Rapid response team (RRT) activations are linked to more goals of care (GOC) discussions and code status changes, especially for patients moved to the ICU. Early GOC discussions are crucial for hospitalized patients facing clinical deterioration.

Keywords:

code status comfort care critical care decompensation goals of care rapid response team

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Last Updated: Sep 13, 2025

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

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Published on: January 15, 2017

Area of Science:

Medical Care
Patient Outcomes
Clinical Deterioration Management

Background:

Rapid response teams (RRT) are standard for hospitalized patients experiencing clinical deterioration.
The association between RRT activations and goals of care (GOC) discussions requires further investigation.

Purpose of the Study:

To determine if RRT activations correlate with subsequent GOC discussions.
To assess the impact of RRT on code status changes and patient outcomes.

Main Methods:

Retrospective analysis of adult patients on medicine services with RRT activations (January-December 2023).
Primary outcome: GOC discussion within 72 hours of RRT activation.
Secondary outcomes: code status change, transition to comfort care, 30/90-day mortality; adjusted for confounding factors.

Main Results:

Patients transferred to the ICU post-RRT showed significantly higher odds of GOC discussions (OR 1.52), code status changes (OR 2.43), and comfort care transitions (OR 1.47).
ICU transfer was also associated with increased 30-day (OR 1.39) and 90-day mortality (OR 1.30).

Conclusions:

ICU transfer after RRT activation strongly predicts downstream GOC discussions, code status modifications, and comfort-focused care.
Highlights the importance of proactive GOC discussions, irrespective of anticipated clinical decline.