The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

RAPID RESPONSE: ARE WE MAKING A DIFFERENCE

Suzan Herzig, Eugene De Guzman, Daniel Davis; Respiratory Care, UCSD Medical Center, San Diego, CA

BACKGROUND: In 2004, the Institute for Healthcare Improvement (IHI) initiated a patient safety plan called the “100,000 Lives Campaign. This plan included the implementation of a “Rapid Response Team”(RRT):The intention was to ensure positive patient outcomes by fostering collaboration between nurses, respiratory therapists and physicians in the care of patients through assessment, communication, immediate interventions, and support. UCSD started with a “front loaded” rapid response program focusing on detection rather than response. Charge nurses as well as critical care nurses are trained. This pilot program transitioned into a permanent team in 2007 and staff is trained regularly on rapid response concepts. We sought to evaluate and report patient outcomes of implementing a RRT. METHOD: Data was extracted from the medical centers Electronic Quality Variance Report (EQVR) system in which the circumstances and outcomes of all code blues and rapid responses are captured. We compared the number of code blue events and outcomes prior to having a RRT program in place in contrast to post program implementation. RESULTS: Chief complaint categories, in order of occurrences, were Respiratory, Cardiovascular, Altered LOC, Other, Fall, and lastly Intuition. Before the initiation of the RRT, the number of non-ICU arrest related deaths was 2.14 per 1000 patients discharged. In 2009 the number fell to O.34.The number of ICU arrest related deaths pre RRT changed slightly from 1.47 per 1000 patients discharged to 1.5. Baseline Cardiopulmonary arrests in non-ICU patients were 2.7 and in the ICU were 1.0 per 1000 patients discharged. Results in 2009 respectively were 0.8 and 2. For non ICU and ICU patients combined, patient survival to discharge was initially 21% and increased to 36% post RRT implementation. Post cardiac arrest survival to discharge with good neurological outcomes improved from 11% to 22%. CONCLUSIONS: With this comprehensive evidence, we can conclude that Rapid Response teams provide timely interventions resulting in fewer transitions to cardiac arrest in non ICU settings and improved clinical outcomes and survival to discharge. Respiratory Care Practitioners serve a valued role in such teams and contribute to improved outcomes. Sponsored Research - None