Daniel P Davis1, Steve A Aguilar1, Patricia G Graham2, Brenna Lawrence3, Rebecca E Sell4, Anushirvan Minokadeh5, Ruchika D Husa6. 1. Department of Emergency Medicine, University of California-San Diego, San Diego, California. 2. Department of Nursing Education, Development, Research, University of California-San Diego, San Diego, California. 3. Department of Nursing, University of California-San Diego, San Diego, California. 4. Division of Pulmonary and Critical Care Medicine, University of California-San Diego, San Diego, California. 5. Department of Anesthesiology, University of California-San Diego, San Diego, California. 6. Division of Cardiology, University of California-San Diego, San Diego, California, and the Division of Cardiology, The Ohio State University, Columbus, Ohio.
Abstract
BACKGROUND: In-hospital cardiopulmonary arrest (CPA) accounts for substantial morbidity and mortality. Rapid response teams (RRTs) are designed to prevent non-intensive care unit (ICU) CPA through early detection and intervention. However, existing evidence has not consistently demonstrated a clear benefit. OBJECTIVE: To explore the effectiveness of a novel RRT program design to decrease non-ICU CPA and overall hospital mortality. METHODS: This study was conducted from the start of fiscal year 2005 to 2011. In November 2007, our hospitals implemented RRTs as part of a novel resuscitation program. Charge nurses from each inpatient unit underwent training as unit-specific RRT members. Additionally, all inpatient staff received annual training in RRT concepts including surveillance and recognition of deterioration. We compared the incidence of ICU and non-ICU CPA from first complete preimplementation year 2006 to postimplementation years 2007 to 2011. Overall hospital mortality was also reported. RESULTS: The incidence of non-ICU CPA decreased, whereas the incidence of ICU CPA remained unchanged. Overall hospital mortality also decreased (2.12% to 1.74%, P < 0.001). The year-over-year change in RRT activations was inversely related to the change in Code Blue activations for each inpatient unit (r = -0.68, P < 0.001). CONCLUSION: Our novel RRT program was associated with a decreased incidence of non-ICU CPA and improved hospital mortality.
BACKGROUND: In-hospital cardiopulmonary arrest (CPA) accounts for substantial morbidity and mortality. Rapid response teams (RRTs) are designed to prevent non-intensive care unit (ICU) CPA through early detection and intervention. However, existing evidence has not consistently demonstrated a clear benefit. OBJECTIVE: To explore the effectiveness of a novel RRT program design to decrease non-ICU CPA and overall hospital mortality. METHODS: This study was conducted from the start of fiscal year 2005 to 2011. In November 2007, our hospitals implemented RRTs as part of a novel resuscitation program. Charge nurses from each inpatient unit underwent training as unit-specific RRT members. Additionally, all inpatient staff received annual training in RRT concepts including surveillance and recognition of deterioration. We compared the incidence of ICU and non-ICU CPA from first complete preimplementation year 2006 to postimplementation years 2007 to 2011. Overall hospital mortality was also reported. RESULTS: The incidence of non-ICU CPA decreased, whereas the incidence of ICU CPA remained unchanged. Overall hospital mortality also decreased (2.12% to 1.74%, P < 0.001). The year-over-year change in RRT activations was inversely related to the change in Code Blue activations for each inpatient unit (r = -0.68, P < 0.001). CONCLUSION: Our novel RRT program was associated with a decreased incidence of non-ICU CPA and improved hospital mortality.
Authors: Marin H Kollef; Kevin Heard; Yixin Chen; Chenyang Lu; Nelda Martin; Thomas Bailey Journal: Am J Med Qual Date: 2016-07-09 Impact factor: 1.852