Overview
Rapid Response Teams (RRT) are one of the changes our hospital is committed to implementing across its
league of hospitals as part of the Institute for Healthcare Improvement (IHI) 100,000
Lives Campaign. In our hospital, the RRTs are known as S.T.A.R.T. (). The prinicpal goal
of RRTs is to prevent patient death outside of the intensive care setting. Quite simply,
the RRT is deployed at the first sign of patient decline, and is made up of a group of
clinicians who can deliver critical care expertise at the bedside. The RRT can be
summoned anytime by anyone in the hospital, helping patients that may looka acutely ill,
before they progressively fail and suffer an adverse event (e.g. cardiac arrest).
Background
Among hospitalized patients, adverse cardiac events are one of the most common
and serious complications, occurring in 0.5% of medical and 0.6% of surgical
patients. Unfortunately, only 17% of patients who experience a cardiac arrest
survive to discharge, with higher survival rates for patients in monitored units
as opposed to non-monitored units. Typically, before a cardiac arrest occurs, most
patients display some form of identifiable signs of deterioration, such as abnormal
vital signs and/or hypoxia.
Intervention during these early signs of deterioration can provide significant
improvements in patient outcomes and mortality. For example, sites that have
already implemented RRTs in medical units have reported reductions in the number
of cardiac arrests and deaths, and reduction in number of ICU and hospital bed-days
among cardiac arrest survivors. For surgical patients, sites have shown reductions
in number of ICU admissions, length of stay, and postoperative mortality, and
reduction in incidence of respiratory failure, stroke, severe sepsis, and acute
renal failure. RRTs have also shown improved survival among coded patients and reduce
the overall rate of CPR events.
Implementation at CCH
Implementing RRTs at CCH began with reviews of the literature and discussion with
clinical leadership. During July 2009~Dec 2009, our focus was on introducing and
implementing RRTs hospital wide in the main Nanguo hospital campus. Following initial
implementation, we will continue to follow the data on key outcomes and RRT utilization.
This web site will serve as a continue resource on our experiences, tools,
results and links to other work on RRT, so that shared learning and improvement
continues.