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Intensivist Staffing of a Tertiary Academic Rapid Response System: Perceptions of Added Value FREE TO VIEW

Sammy Pedram, MD; Markos Kashiouris, MD; Shannon Lubin, CCRN; Kristin Miller, MD; Orlando Debesa, DO; Ray Shepherd, MD; Thomas Iden, MD; Rajiv Malhotra, DO; Curtis Sessler, MD
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Virginia Commonwealth University, Richmond, VA

Chest. 2015;148(4_MeetingAbstracts):491A. doi:10.1378/chest.2254174
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SESSION TITLE: Process Improvement in Obstructive Lung Disease Education, Pneumonia Readmissions and Rapid Response Systems II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To investigate the frontline provider satisfaction and perceived effectiveness of adding a Daytime Intensivist (DI) to an existing rapid response system (RRS). Intensivists participated in rapid response team (RRT) calls, as well as code blue calls, and Coronary ICU consultation.

METHODS: The DI program was implemented in October 2014. On March 2015 DIs, RRT nurses, and ward bedside nurses completed survey instruments (12, 10, and 4 questions, respectively) about the effectiveness of the program. Questions included a 5-point Likert scale (4 = strongly positive, 2 = neutral, 0 = strongly negative) or free text responses.

RESULTS: 100% (7/7) of DIs, 100% (7/7) of RRT nurses, and 73 ward nurses responded. DIs rated the experience as fulfilling (median score 3, IQR [3-4]). They perceived strengthened patient safety outside the ICU (median 4, IQR [4-4]), timely care (median 4, IQR[4-4]) and triage (median 4, IQR [4-4]). The RRT nurses felt satisfied with the DIs (median 4, IQR [3-4]), perceived superior communication with the primary physician teams (median 3, IQR [3-4]), superior code blue performance (median 4, IQR [2-4]), and importance for patient safety (median 4, IQR [4-4]). Bedside nurses felt that their patients received more timely lifesaving interventions (median 4, IQR [3-4]) and triage (median 4, IQR [3-4]). In response to the hypothetical question, “in the event a close relative was hospitalized, I would have been more comforted to know that a DI was available in the hospital”, participants indicated that they strongly agreed (DIs median 4, IQR [3-4], RRT nurses median 4, IQR [4-4] and bedside nurses median 4, IQR [3-4]). There were no negative ratings to any question by any survey respondent.

CONCLUSIONS: Six months post its implementation, ward nurses, RRT nurses, and Intensivists perceived the DI program as feasible, effective, and highly beneficial to patient safety.

CLINICAL IMPLICATIONS: The addition of a dedicated Intensivist to an existing rapid response system was widely perceived as highly valuable to the care of clinically unstable ward patients.

DISCLOSURE: The following authors have nothing to disclose: Sammy Pedram, Markos Kashiouris, Shannon Lubin, Kristin Miller, Orlando Debesa, Ray Shepherd, Thomas Iden, Rajiv Malhotra, Curtis Sessler

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