PURPOSE: In 2000, Christiana Care Health Services (CCHS) developed the Stabilization, Telemetry, Administration, Teaching (STAT) Nurse program to provide a critical care nurse as a resource to the nursing units. This program was implemented to support the growth of flexible telemetry capability to every hospital bed. In 2005, that program was expanded to the Rapid Response Team (RRT) by the addition of a respiratory therapist and a senior medical resident. The goal of the program was twofold: first, to provide skilled medical assessment and treatment rapidly; and secondly, to train medical staff to recognize the subtle, early warning signs of patient deterioration. We compared outcome data from the STAT nurse program to the RRT program.
METHODS: The RRT was implemented in a staged fashion, with frequent review by a multi-disciplinary implementation committee and quarterly review by a global steering committee. Outcome data including logs of all RRT calls was compiled.
RESULTS: Since initiating the RRT, the hospital mortality rate has decreased from 2.17% to 2.06%, representing a difference of 64 lives. Data from the RRT has shown that the number of calls requiring ICU admission declined significantly from 39% to 30% (p<=.01). Non-ICU codes decreased by 20% (p<.01) and total hospital codes fell 22% (p<.001).
CONCLUSION: A significant reduction in hospital mortality, non-ICU codes, and total hospital codes was obtained by the implementation of the RRT program. Additionally, RRT calls requiring ICU admission has also declined.
CLINICAL IMPLICATIONS: Despite having a critical care resource program from 2000-2005, the evolution to the team approach of the RRT program has established a significantly better mechanism to respond to the subtle signs of patient deterioration earlier and has contributed to the decrease in frequency of cardiopulmonary arrests and overall hospital mortality.
DISCLOSURE: Marc Zubrow, None.