Impact of proactive rounding by a rapid response team on patient outcomes at an academic medical center.

Abstract

BACKGROUND: The impact of rapid response teams (RRT) on patient outcomes remains uncertain. OBJECTIVE: To examine the effect of proactive rounding by an RRT on outcomes of hospitalized adults discharged from intensive care. DESIGN: Retrospective, observational study. SETTING: Academic medical center. PATIENTS: All adult patients discharged alive from the intensive care unit (ICU) at the University of California San Francisco Medical Center between January 2006 and June 2009. INTERVENTION: Introduction of proactive rounding by an RRT. MEASUREMENTS: Outcomes included the ICU readmission rate, ICU average length of stay (LOS), and in-hospital mortality of patients discharged from the ICU. Data were obtained from administrative billing databases and analyzed using an interrupted time series (ITS) model. RESULTS: We analyzed 17 months of preintervention data and 25 months of postintervention data. Introduction of proactive rounding by the RRT did not change the ICU readmission rate (6.7% before vs 7.3% after; P = 0.24), the ICU LOS (5.1 days vs 4.9 days; P = 0.24), or the in-hospital mortality of patients discharged from the ICU (6.0% vs 5.5%; P = 0.24). ITS models testing the impact of proactive rounding on secular trends found no improvement in any of the 3 clinical outcomes relative to their preintervention trends. CONCLUSIONS: Proactive rounding by an RRT did not improve patient outcomes, raising further questions about RRT benefits.