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Evaluation of Rapid Response Team Performance in a Community Hospital Following the Implementation of Multiple Interventions: Interventional Study FREE TO VIEW

Alaa Abu Sayf, MD; Sulaiman Alhassan, MD; Jessica D'Amico, DO; Sue Siriani, RN; Camelia Arsene, MD; Syed Hussain, MD; Thomas Piskorowski, DO
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Sinai Grace Hospital, Detroit, MI

Chest. 2014;146(4_MeetingAbstracts):521A. doi:10.1378/chest.1992301
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SESSION TITLE: Quality & Clinical Improvement (Poster Discussion)

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Rapid Response team (RRT) is an integral part of the hospital quality improvement systems, and has been well studied ( ref) .We have implemented new tools to the RRT, and we want to evaluate the impact of these interventions on patients outcome and quality of care.

METHODS: We have evaluated all the sepsis alert activations, time to response , and non-ICU code blue,at our institution between January 2013 and January 2014 with July 1st 2013 being as the start date of the new interventions .:The intervention has two components : First, RRT nurses have conducted rounds for newly admitted, select patients based on admission diagnosis and SIRS criteria. Second, we have added senior Internal Medicine residents to the RRT structure. The Mann-Whitney U test was conducted to determine mean changes before and after the intervention. SPSS Version 22 was used for analyses. All p-values were two-tailed

RESULTS: Following the intervention, we have observed a statistically significant decrease in the mean number of sepsis alerts activation (11.8 ± 3.6 before intervention to 7.1 ± 2.0 after intervention P = 0.037). In addition, there has been a noticeable improvement in the mean sepsis response time (99.85 ± 69.9 minutes before intervetion to 42.32 ± 21.3 minutes after intervention (p = 0.037). No statistical difference in the number of non ICU code blues/1000 ( 8 ± 2.6 to 7 ± 3.3 , P = 0.76) has been found.

CONCLUSIONS: The results of this study emphasize that the introduction of nurses rounds and medical residents to the structure of the rapid response team has resulted in a valuable improvement in the quality of care provided to critically ill patients We view the reduction in response time as critically important as it will lead to earlier initiation of evidence based Early Goal Directed Therapy (EGDT).

CLINICAL IMPLICATIONS: Further studies are needed to evaluate such an intervention in a larger population and in multicenter base in order to identify other outcomes such as progression of diseases, morbidity, mortality and length of stay.

DISCLOSURE: The following authors have nothing to disclose: Alaa Abu Sayf, Sulaiman Alhassan, Jessica D'Amico, Sue Siriani, Camelia Arsene, Syed Hussain, Thomas Piskorowski

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