Improving A Rapid Response System at a Teaching Hospital: Lessons Learned From Implementation of a Novel Performance Self-Evaluation Tool.

Abstract

Rapid assessment and treatment (RAT) calls, facilitated by rapid response teams (RRTs), have become vital to the care of hospitalized patients whose conditions are deteriorating outside of the ICU in many institutions worldwide. A significant body of data has recognized the efficacy of rapid response systems (RRSs) in improving patient care; however, there is no standardized protocol that all RRSs practice. Even when the recognition of patient clinical deterioration is rapidly noted, further treatment may be delayed because of issues with clinical knowledge and communication between parties present, especially in training institutions. At our institution in Southern California, the RRT consists of resident physicians supervised by an attending physician, a respiratory therapist, a critical care nurse, and a pharmacist. In our study, we assessed our responses to RAT calls at baseline, using a standardized rubric. We then implemented an educational intervention to resident physicians, including clinical and communication components. Finally, we reassessed our responses to RAT calls postintervention. We found that an educational intervention improved patient outcomes and several key process measures in our RRS. This article describes the process and lessons learned from our initiative.