Implementation of SHC’s new Rapid Response Team (RRT) began successfully on December 1 as a patient safety initiative of the Institute of Healthcare Improvement’s 100,000 Lives Campaign.

The SHC RRT consists of a critical care fellow, an ICU nurse, a critical care crisis nurse, and a respiratory therapist who respond to urgent calls within 10 minutes. The team can be activated by nurses, physicians, respiratory therapists, nurse practitioners, or physician assistants when they identify patients who need urgent medical attention.

“We’ve been very pleased with the use of the RRT thus far, with the team responding to 20 bedside calls between Dec. 1-28,” said Ann Weinacker, assistant professor of medicine and team leader of the RRT initiative. “Nurses have told us that they feel comfortable calling the RRT and have been pleased with its performance. Housestaff and attending physicians have already seen the advantage of having such a team, especially when they are not immediately available to provide care in urgent situations,” said Weinacker, who specializes in critical care medicine.

The reasons for calls to the RRT have varied widely but have typically included acute respiratory insufficiency, hypotension, tachydysrhythmias, and drug or blood product reactions. Although most of the calls have been made by staff nurses, two calls have been collaboratively initiated by the primary medical team and the bedside nurse. Thirteen of the 20 calls resulted in patients being transferred to either a monitored bed or an ICU.

One of the first successful RRT calls involved a 44 year-old woman recovering from a laparoscopic hysterectomy who experienced rapid onset of a supraventricular tachycardia, Weinacker said. The B1 staff nurse appropriately called the surgical resident STAT for an evaluation. The nurse and resident quickly decided to call the RRT, which responded in less than three minutes and promptly treated the patient with intravenous adenosine and a beta-blocker. The patient was transferred in less than 15 minutes to D1 CSU [coronary surveillance unit] for further monitoring, and a cardiology consult was ordered and completed within 30 minutes. The patient was placed on appropriate therapy and was discharged home two days later.

The first formal analysis of the RRT calls and evaluation of the performance of the team will be reported at the March meeting of the Quality Improvement and Patient Safety Committee. A summary of the report is expected to be released for publication in the April edition of Medical Staff Update.