Paper: Rapid Response Teams: A Systematic Review of Patient Outcomes and Hospital Narratives (40th Biennial Convention (October 31st- November 4th, 2009))

Monday, November 2, 2009: 4:10 PM

Deonni P. Stolldorf, RN, MCur, APRN-BC
Health care quality and patient outcomes, University of North Carolina, Chapel Hill, Chapel Hill, NC

Presentation File (PDF Format)

Learning Objective 1: define rapid response teams and their role in acute care hospitals.

Learning Objective 2: describe strategies for successful implementation of rapid response teams in acute care hospitals

Rapid response teams (RRTs) were birthed in Australia in 1990 and were introduced to the United States health care system in December of 2004 when the Institute for Healthcare Improvement launched the “100 000 Lives” Campaign. The goal of the Campaign was to save 100 000 lives in 18 months by decreasing patient mortality and morbidity through six interventions. One of six initiatives was the implementation of Rapid Response Teams. RRTs are a group of experts, usually a critical care nurse, physician and respiratory therapist, who is called to the bedside of a potentially deteriorating patient on an acute care unit. It is estimated that 3 103 hospitals have joined the campaign and by June, 2006, the IHI reported that 122,300 lives have been saved. RRTs have now also been adopted in the United Kingdom and other European nations.

Research studies conducted on these teams have yielded different results than what was reported by the IHI and the effectiveness of RRTs as a strategy to decrease patient mortality remains questionable. Therefore, a systematic literature review was conducted to bring clarity to this issue.

The aim of the systematic review was to examine (1) the research literature to explore relationships between patient outcomes and hospital characteristics, RRT staffing structure, training of hospital staff and RRT members, RRT calling criteria, and subsequent patient outcomes, and (2) hospital narratives of RRT implementation strategies and reported outcomes and the perceived benefits of RRTs by these organizations. Donabedian’s model of structure, process, and outcomes was used as the conceptual framework for the study. Cooper’s (1982) guidelines on integrative research reviews were used to guide the review process. Inconsistencies on the conceptualization, implementation of RRTs, and patient outcomes were identified. Perceived benefits of RRTs observed include increased staff satisfaction and improved communication between care providers.

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