CONTEXT: Adverse events are estimated to affect up to 17% of hospitalized patients and to cause up to 98,000 patient deaths per year in the United States. Unexpected codes in hospitalized patients are one of the most significant adverse events, carrying a risk of death that is reported to range from 50% to 80%. OBJECTIVE: The Rapid Medical Response Team (RMRT) was an initiative designed to reduce adverse events, specifically failure to rescue, leading to nonintensive care unit (nonICU) codes. This initiative was funded, as part of the Transforming Care at the Bedside (TCAB) program, by a grant from the Robert Wood Johnson Foundation. DESIGN: To determine whether the RMRT had a significant impact on our nonICU code rate, we did a retrospective, noncohort comparison of 2004 (preRMRT) data with 2005 (postRMRT) data. MAIN OUTCOME MEASURES: Our main outcome measures were nonICU codes, mortality rate, and unplanned patient transfers to the intensive care unit (ICU). RESULTS: There was a decrease in the nonICU code rate per 1000 discharges from 1.90 in 2004 to 1.01 in 2005. Implementation of the RMRT correlates to a statistically significant decrease in the nonICU code rate (p = .018; relative risk, 0.53 [95% confidence interval, 0.31-0.91]). The nonICU mortality rate remained unchanged at 2.01%. The unplanned ICU transfer rate for 2005 was 47%. CONCLUSIONS: Implementation of RMRTs can decrease nonICU code rates and the rate of unplanned ICU transfers. RMRTs can empower staff, enhance expertise and communication skills, and support a culture of safety.
CONTEXT: Adverse events are estimated to affect up to 17% of hospitalized patients and to cause up to 98,000 patient deaths per year in the United States. Unexpected codes in hospitalized patients are one of the most significant adverse events, carrying a risk of death that is reported to range from 50% to 80%. OBJECTIVE: The Rapid Medical Response Team (RMRT) was an initiative designed to reduce adverse events, specifically failure to rescue, leading to nonintensive care unit (nonICU) codes. This initiative was funded, as part of the Transforming Care at the Bedside (TCAB) program, by a grant from the Robert Wood Johnson Foundation. DESIGN: To determine whether the RMRT had a significant impact on our nonICU code rate, we did a retrospective, noncohort comparison of 2004 (preRMRT) data with 2005 (postRMRT) data. MAIN OUTCOME MEASURES: Our main outcome measures were nonICU codes, mortality rate, and unplanned patient transfers to the intensive care unit (ICU). RESULTS: There was a decrease in the nonICU code rate per 1000 discharges from 1.90 in 2004 to 1.01 in 2005. Implementation of the RMRT correlates to a statistically significant decrease in the nonICU code rate (p = .018; relative risk, 0.53 [95% confidence interval, 0.31-0.91]). The nonICU mortality rate remained unchanged at 2.01%. The unplanned ICU transfer rate for 2005 was 47%. CONCLUSIONS: Implementation of RMRTs can decrease nonICU code rates and the rate of unplanned ICU transfers. RMRTs can empower staff, enhance expertise and communication skills, and support a culture of safety.
Authors: Ken Hillman; Jack Chen; Michelle Cretikos; Rinaldo Bellomo; Daniel Brown; Gordon Doig; Simon Finfer; Arthas Flabouris Journal: Lancet Date: 2005 Jun 18-24 Impact factor: 79.321
Authors: Rinaldo Bellomo; Donna Goldsmith; Shigehiko Uchino; Jonathan Buckmaster; Graeme Hart; Helen Opdam; William Silvester; Laurie Doolan; Geoffrey Gutteridge Journal: Crit Care Med Date: 2004-04 Impact factor: 7.598
Authors: Jasmeet Soar; Mary E Mancini; Farhan Bhanji; John E Billi; Jennifer Dennett; Judith Finn; Matthew Huei-Ming Ma; Gavin D Perkins; David L Rodgers; Mary Fran Hazinski; Ian Jacobs; Peter T Morley Journal: Resuscitation Date: 2010-10 Impact factor: 5.262
Authors: Ana Luiza Mezzaroba; Marcos Toshiyuki Tanita; Josiane Festti; Claudia Maria Dantas de Maio Carrilho; Lucienne Tibery Queiroz Cardoso; Cintia Magalhães Carvalho Grion Journal: Rev Bras Ter Intensiva Date: 2016-09-09