Effect of a Rapid Response Team on Hospital-wide Mortality and Code Rates Outside the ICU in a Children’s Hospital

Abstract

Institute of Medicine concluded that between 44 000 and 98 000 deaths per year occur in hospitals in the United States as a result of errors. Since publication, these data have captured the attention of the nation, 2,3 resulting in aggressive calls for further research, 4,5 regulatory interventions, [6][7][8] third-party payer involvement, 9,10 and health care organization initiatives to improve this situation. One such initiative, promoted by the Institute for Healthcare Improvement known as the 100 000 Lives Campaign, recommended 6 strategies to decrease the number of preventable inpatient deaths in the United States by 100 000 during the period between December 2004 and June 2006. 11 One of these 6 recommended strategies was the implementation of a rapid response team (RRT).An RRT, also known as a medical response team or medical emergency team, is a multidisciplinary team most frequently consisting of intensive care For editorial comment see p 2311.

Implementing a Rapid Response Team

“…This finding is in line with several earlier studies 35,36 . Studies have reported variable rates of RRT activations, lower rates at 25.8 per 1000 admissions by Jones et al 7 and higher rates of activation at 69.1 per 1000 admissions by Lyons et al 14 Implementing an RRT increases activations, which has been shown to decrease overall mortality in hospitals 37 …”

Improving Communication by Standardizing Pediatric Rapid Response Team Documentation

“…An increased frequency of primarily acute neurological situations likely accounts for a higher postintervention transfer rate. We found after RRT activation, it took on an average of 4.1 minutes for the team to arrive to the bedside, which is superior to what Sharek et al 4 expected to achieve in their study. This does seem to be fairly quick for an RRT response, which may be attributed to general awareness of the implementation of this project in the hospital.…”

Association of Pediatric Medical Emergency Teams With Hospital Mortality

“…Although studies have reported a decrease in cardiac arrest rates after implementation of a medical emergency team, 5, 17, 18 the discordance between a reduction in cardiac arrest rates in prior studies and hospital mortality in this study may be due to 4 reasons. First, most prior studies evaluating the effect of medical emergency teams on rates of in-hospital cardiac arrest have not accounted for pre-implementation trends, thus overestimating the benefit of these teams on lowering cardiac arrest rates.…”