PURPOSE: To report our experience with Rapid Response Team (RRT) two years after implementation at an academic medical center and to evaluate triggers for RRT activation, it's impact on hospital mortality and hospital cardiac arrests (code blues).
METHODS: Retrospective analysis of our hospital's RRT database from February 2005 to February 2007.
RESULTS: The RRT was activated for a total of 954 patients. The most common reasons for activation were “worried about,” change in level of consciousness, low oxygen saturation and escalating oxygen requirement. Approximately 8.6% of RRT activations took place outside of inpatient units. 58.5% of patients were transferred to a higher level of care after evaluation by RRT. A total of 73.9% of patients were discharged alive whereas 18.7% expired sometime after activation of RRT. Of those who expired, a quarter do so within the first day, while an unexpected 44% die greater than 7 days after RRT activation. There was an increase of 9.7% in the patients that were discharged alive and a decrease of 29.3% in mortality during the second year after RRT was implemented. The number of RRT activations increased by 74.3% and code blue activation decreased by 10.3% in the second year. Overall there was a trend towards decreased code blues per 1000 discharges, decreased codes outside of the ICU setting, and decreased hospital mortality. Interestingly, over a 2 month sample period roughly 50% of RRT activations were within the first 12 hours of admission. This deserves further exploration and characterization.
CONCLUSION: These results suggest that RRT is capable of improving outcomes in unstable patients who are at risk for clinical deterioration. Nursing satisfaction with the team is high (data not shown). This data raises additional questions concerning early rapid responses after admission and characterization of late mortality after a RRT.
CLINICAL IMPLICATIONS: Our RRT consists of an ICU nurse, respiratory therapist, and when needed, an ICU physician. It is easily implemented and has had a positive impact in 2 years in an academic hospital.
DISCLOSURE: Saurin Patel, No Financial Disclosure Information; No Product/Research Disclosure Information