Thursday, November 18, 2010


Background: Rapid Response Teams (RRT) are groups of healthcare practitioners who respond to acutely-deteriorated hospitalized patients. Various studies have shown that RRT’s may improve patient outcomes. Additionally, the Institute for Healthcare Improvement recommends the implementation of RRT’s as one of their initiatives to improve patient safety outcomes. 

Objective: We implemented an RRT (An Internal Medicine Physician, Registered Respiratory Therapist, Critical Care Registered Nurse and Nursing Supervisor) at Sentara Careplex Hospital in 2005 specifically to reduce the monthly rate of respiratory and cardiopulmonary arrests (codes) external to the intensive care units.
Design: Single center, non-randomized, prospective chart review.
Setting: 199 bed community hospital.
Interventions - The records of patients who required cardiopulmonary resuscitation external to the intensive care areas were reviewed before RRT implementation to determine activation criteria for the RRT. Codes were defined as respiratory or cardiopulmonary arrest. The incidence of these non-ICU codes before and after RRT implementation was recorded. The one-way analysis of variance (ANOVA) was used for statistical testing of differences between years 2004 (pre RRT implementation), 2005, 2006, and 2007. A p value < 0.05 was considered statistically significant.
Results: Previous to RRT implementation, the non-ICU code rate averaged 5.33 events per month. After implementation, the mean non-ICU code rate decreased by an average of 21%. Conversely, when testing for significant differences between pre & post RRT implementation, there were no statistical differences among the four years (p-value 0.15).
Conclusion: Although our facility met its goal by decreasing the non-ICU code rate by 10%, there was no significant statistical difference pre & post RRT implementation. The cost of intensive care unit length of stay and unplanned ICU admissions is of great relevance. Additionally, patient-centered outcomes such as health-related quality of life and hospital mortality rates must be addressed.