Beyond National Averages: Assessing the Applicability of a National Rapid Response Registry to a Mid-sized Urban...

Rapid response teams (RRTs) manage deteriorating patients. National benchmarks, like the GWTG-R-MET (Get With The Guidelines-Resuscitation - Medical Emergency Team) registry, guide RRT practices, but their applicability to diverse settings like mid-sized community teaching hospitals is unclear. This study compares RRT characteristics at such a hospital to national registry data to assess applicability and identify local distinctions. We analyzed RRT activations (n = 912) at our institution (July 2022-March 2024) using rapid response (RR) sheets and electronic health record data, including demographics, triggers, disposition, mortality, and International Classification of Diseases, Tenth Edition (ICD-10) coding. Data were recoded to align with published GWTG-R-MET categories (n = 347,401) for direct comparison using chi-squared tests (p < 0.05, significant). Compared to the registry, our hospital had significantly more activations for non-Hispanic Black patients (75.9% vs. 19.7%, p < 0.001) and fewer for non-Hispanic White patients (17.8% vs. 67.2%, p < 0.001). Neurological triggers were higher locally (41.7% vs. 30.7%, p < 0.001), driven by altered mental status and stroke suspicion. Chest pain triggers were markedly higher (16.1% vs. 4.6%, p < 0.001), while respiratory triggers were significantly lower (12.7% vs. 38.0%, p < 0.001). More patients remained on their unit post-RRT (70.4% vs. 54.9%, p < 0.001), fewer transferred to ICU (21.5% vs. 30.0%, p < 0.001), and inpatient mortality was lower (5.8% vs. 14.3%, p < 0.001). National RRT registries provide a valuable framework for understanding RRT practices, but significant local variations in patient demographics, activation patterns, disposition, and outcomes exist. The observed variations highlight the necessity for each hospital to undertake a localized RRT needs assessment to inform tailored improvement strategies and education programs.