The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

STAGED IMPLEMENTATION OF A RAPID RESPONSE TEAM WITH A CONTINUAL FEEDBACK LOOP

Suzanne Iniguez1, Lee W. Evey1, Sharon Jacobson2



Background: In 1996, the Institute of Medicine (IOM) launched a concerted, ongoing effort focused on assessing and improving the nation's quality of care. The IOM Definition of Quality: "The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." The Joint Commission has listed as one of its National Patient Safety Goals to "improve recognition and response to changes in a patient's condition." Our institution chose to initiate a Rapid Response Team (RRT) to meet this goal.

Methods: A multidisciplinary committee was formed to develop the team composition, formulate a policy and to define a stepwise approach to implementation. The RRT is comprised of an ICU Fellow, RN and RT with an anticipated response time of 15 minutes. The policy delineates indications for calling an RRT, back up team composition as well as SBAR use. The committee also made the recommendation to take an I-STAT to each call to facilitate rapid lab results at the bedside if needed. A comprehensive Responder Form was created to ensure event documentation and notification of the primary medical group, it also included follow-up with the RRT caller. The committee met weekly to evaluate the preceeding weeks RRT calls and to identify opportunities for improvement.

Results: The RRT was initially piloted on two floors and then went housewide in scheduled stages. Due to the initial planning of the committee and the involvement of all key stakeholders the process stayed on track. The weekly meetings were key in ensuring that we developed the best process for our facility; from the call being received through our telecom center, to the rapid transfer of the patient to a higher level of care if needed.

Conclusion: The continual feedback that was facilitated by our weekly meetings and review of calls ensured that we evaluated our RRT response thoroughly. Electronic surveys that were given to all of the callers and responders showed that after one year caller satisfaction improved from 80% to 97%, bedside Resident's satisfaction went from 80% to 94% and the responding teams comfort level increased from 75% to 97%.