The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

Developing a Rapid Response Team in a Learning Institution for Improved Patient Care

 Pickett, Dorothy, CCRN, RN, Wendy Sliverstein, RN Alan Wyatt, RRT-NPS,
Amar Bukhari, MD Saint Peter's University Hospital, New Brunswick, NJ

Introduction: The Institute for Healthcare Improvement (IHI) has recommended the development of Rapid Response Teams (RRT) for decreasing the number of cardiopulmonary arrests, increase survival rate and decrease the number of patients requiring to be admitted to critical care.  The premise that the team was developed from was the Missouri Baptist Medical Center in St. Louis Missouri[i]. The purpose is to try and recreate a similar program in Saint Peter's University Hospital in New Brunswick, NJ.

Method: The team was developed under a group effort with Medical Director/Intensivists, Critical Care Nursing, Respiratory Care Department and Performance Improvement Department.  Point of Care testing was also included for planning for a Blood Gas/Chemistry analyzer[ii].  Information was gathered by both the PI coordinator and the ICU Coordinator.  The respiratory therapist and critical care nurse started the assessment of the patient determining vital signs and if indicated ABG's with electrolytes and Hematocrit.  Either an intensivists attending would be at the scene or a hospitalist.  The RRT was actually initiated at the end of September 2005 and data is included up to April 2006.

Results:  The initial response was a higher number of RRT calls, January being the highest.  Since then the numbers have decreased.  Total numbers of patients seen: 164.  Our mortality rate of the rapid response calls are 3%.  The trend appears for Code Blue calls have not been evident at this time.  Our ability to improve on a more rapid stabilization of the patient has been successful.

Conclusions:  The initial conclusion is that we have not seen a decrease in code blue patients in distress have been assessed and stabilized in a timelier manner.  We continue to monitor and improve on our response and outcomes with continued learning for the staff with as we start this new program.

[i] Rapid Response Teams: Heading Off Medical Crises at Baptist Memorial Hospital-Memphis. Boston: Institute for Healthcare Improvement.

[ii] The decision by the RRT committee was to choose the Irma which included the ABG and Na, K, Cl, iCa, and Hct
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