TeamSTEPPS for Rapid Response Systems

[Pages:52]TM

for

Rapid Response Systems

RRS

Overview

What is the Rapid Response System? The Rapid Response System (RRS) is the overarching structure that coordinates all teams involved in a rapid response call

What is TeamSTEPPS? The Agency for Healthcare Research and Quality's curriculum and materials for teaching teamwork tools and strategies to healthcare professionals This module of TeamSTEPPS is for RRS

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Overview

What is the Rapid Response Team? RRS has several parts, one of them being the Rapid Response Team (RRT) A RRT ? known by some as the Medical Emergency Team ? is a team of clinicians who bring critical care expertise to the patient's bedside or wherever it is needed (IHI, 2007)

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Why Should You Care?

People die unnecessarily every day in our hospitals It is likely that each of you can provide an example of a

patient who, in retrospect, should not have died during his or her hospitalization There are often clear early warning signs of deterioration Establishing a RRS is one of the Joint Commission's 2008 National Patient Safety Goals Teamwork is critical to successful rapid response The evidence suggests that RRS work!

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Does it Work?

No. of cardiac arrests Deaths from cardiac arrest No. of days in ICU post arrest No. of days in hospital after arrest Inpatient deaths

Before 63 37 163

1363 302

After 22 16 33 159 222

Bellomo R, Goldsmith D, Uchino S, et al. A prospective before-and-after trial of a medical emergency team. Medical Journal of Australia. 2003;179(6):283-287.

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Does the RRS Work?

50% reduction in non-ICU arrests

Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital:

preliminary study. BMJ. 2002;324:387-390.

Reduced post-operative emergency ICU transfers (58%) and deaths (37%)

Bellomo R, Goldsmith D, Uchino S, et al. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32:916-921.

Reduction in arrest prior to ICU transfer (4% vs. 30%)

Goldhill DR, Worthington L, Mulcahy A, Tarling M, Sumner A. The patient-at-risk team: identifying and managing seriously ill ward patients. Anesthesia. 1999;54(9):853-860.

17% decrease in the incidence of cardiopulmonary arrests (6.5 vs. 5.4 per 1000 admissions)

DeVita MA, Braithwaite RS, Mahidhara R, Stuart S, Foraida M, Simmons RL. Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Qual Saf Health Care. 2004;13(4):251-254.

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NQF Safe Practices

In 2003, the National Quality Forum (NQF) identified the RRS as a chief example of a team intervention serving the safe practice element of Team Training and Team Interventions RRSs are viewed as an ideal example of safe practices in teamwork meeting the objective of establishing a proactive systemic approach to team-based care

In 2006, the NQF updated their Safe Practices recommendations NQF continues to endorse RRSs and concludes that annually organizations should formally evaluate the opportunity for using rapid response systems to address the issues of deteriorating patients (NQF, 2006)

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Joint Commission 2008 National Patient Safety Goal

Goal 16: Improve recognition and response to changes in a patient's condition

16A. The organization selects a suitable method that enables health care staff members to directly request additional assistance from a specially trained individual(s) when the patient's condition appears to be worsening

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