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Original Research: CRITICAL CARE |

Rapid Response Team in an Academic Institution: Does It Make a Difference?

Shiwan K. Shah, DO; Victor J. Cardenas, Jr, MD; Yong-Fang Kuo, PhD; Gulshan Sharma, MD, MPH; MERIT Study Investigators for the Simpson Centre
Author and Funding Information

From the Departments of Internal Medicine and Pediatrics (Dr Shah), the Division of Pulmonary, Allergy, and Critical Care Medicine (Drs Cardenas and Sharma), and the Sealy Center on Aging, Department of Internal Medicine (Drs Kuo and Sharma), University of Texas Medical Branch, Galveston, TX.

Correspondence to: Gulshan Sharma, MD, MPH, Division of Pulmonary, Allergy, and Critical Care Medicine, 301 University Blvd, Galveston, TX 77555-0561; e-mail: gulshan.sharma@utmb.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(6):1361-1367. doi:10.1378/chest.10-0556
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Background:  Although data remain contradictory, rapid response systems are implemented across US hospitals. We aimed to determine whether implementation of a rapid response team (RRT) in a tertiary academic hospital improved outcomes.

Methods:  Our hospital is a tertiary academic medical center with 24-h in-house resident coverage. We conducted a retrospective cohort study comparing 27 months after implementation of the RRT (April 1, 2006, to June 31, 2008) and 9 months before (January 1, 2005, to September 31, 2005). Outcomes included incidence of codes (cardiac and/or respiratory arrests), outcome of the codes, and overall hospital mortality.

Results:  We analyzed 16,244 nonobstetrics hospital admissions and 70,208 patient days in the control period and 45,145 nonobstetrics hospital admissions and 161,097 patient days after the RRT was implemented. The RRT was activated 1,206 times (7.7 calls per 1,000 patient days). There was no difference in the code rate (0.83 vs 0.98 per 1,000 patient days, P = .3). There was a modest but nonsustained improvement in nonobstetrics hospital mortality during the study period (2.40% vs 2.15%; P = .05), which could not be explained by the RRT effect on code rates. The mortality was 2.40% in the control group and 2.06%, 1.94%, and 2.46%, respectively, during the next three consecutive 9-month intervals.

Conclusions:  In our single-institution study involving an academic hospital with 24-h in-house coverage, we found that RRT implementation did not reduce code rates in the 27 months after intervention. Although there was a decrease in overall hospital mortality, this decrease was small, nonsustained, and not explained by the RRT effect on code rates.

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