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Learning Objective 1: The learner will be able to evaluate and discuss the effectiveness of a rapid response team in an urban hospital setting.
Learning Objective 2: The learner will be able to compare the results of the research study to current rapid response literature.
Purpose
Limited studies exist on the effect of rapid response team(RRT) implementation on mortality, with some reporting mortality rates unchanged pre or post implementation of RRT (Bellomo, et. al., 2004; Chan et. al., 2008; Dacey, et. al., 2007; Winters, et. al., 2007). Therefore, the purpose of this study was to determine if the implementation of a rapid response team (RRT) by a southwestern, urban hospital significantly reduced the number of respiratory and cardiac arrests outside the intensive care unit. The study used the concept of failure to rescue as a framework by examining the proportion of patients who had an incidence of cardiac/respiratory failure pre implementation and post implementation of the RRT.
Methods
A retrospective descriptive study was conducted with targeted subjects being the proportion of patients reported to incur cardiac or respiratory arrest outside the intensive care unit per 1000 discharges. The study evaluated the proportion of the patients with incidence of cardiac and respiratory arrests occurring January 2005 to December 2005, one year prior to implementation of the RRT. The 2005 data was compared to the incidence of cardiac and respiratory arrests occurring January 2009 to December 2009, two years after implementation of the RRT.
Results
Statistical analyses were derived using proportionate sampling. The P value was calculated using a z test. Because the p value, 0.67 was greater than 0.05 or 5 % significance, the study showed no statistical difference in cardiac or respiratory arrests rates pre and post implementation of the RRT.
Conclusion
National efforts to improve patient outcomes should be supported by sufficiently strong evidence to warrant such a commitment to resource. Although failure to rescue is a known concern this study, along with others, suggests implementation of RRT does not improve patient outcomes, therefore questioning the channeling of resources towards RRT.
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