Premium
Rapid response: A quality improvement conundrum
Author(s) -
Prado Renata,
Albert Richard K.,
Mehler Philip S.,
Chu Eugene S.
Publication year - 2009
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.430
Subject(s) - medicine , rapid response team , decompensation , intensive care medicine , intensive care unit , early warning score , medical emergency , quality management , adverse effect , vital signs , health care , emergency medicine , surgery , management system , management , economics , economic growth
Many in‐hospital cardiac arrests and other adverse events are heralded by warning signs that are evident in the preceding 6 to 8 hours. By promptly intervening before further deterioration occurs, rapid response teams (RRTs) are designed to decrease unexpected intensive care unit (ICU) transfers, cardiac arrests, and inpatient mortality. While implementing RRTs is 1 of the 6 initiatives recommended by the Institute for Healthcare Improvement, data supporting their effectiveness is equivocal. Before implementing an RRT in our institution, we reviewed cases of failure to rescue and found that (1) poor outcomes were often associated with attempts to manage early decompensations without a bedside evaluation, and (2) the common causes of decompensation for floor patients (early sepsis, aspiration, pulmonary embolism) were within the scope of our primary teams' practice. Therefore, we felt that prompt, mandatory bedside evaluations by the primary team would decrease untoward outcomes. Journal of Hospital Medicine 2009;4:255–257. © 2009 Society of Hospital Medicine.