Rapid Response Teams Improve Quality/Safety

As hospitals strive to improve the quality and safety of the care they provide, the systems they use to care for critically ill patients are getting an overhaul—including systems for responding to patients when their conditions worsen. More than 80% of respondents to an April 2006 Healthcare Risk Control(HRC) System online poll indicated that they have implemented rapid response teams (RRTs) in their facilities to respond to potentially life-threatening events. RRTs (also called "medical emergency teams" METs) differ from the usual "code blue" or "code 99" team that is called when a patient suffers cardiac or respiratory arrest. Based on the notion of early intervention, RRTs are trained to respond before a patient requires the code team; their aim is to intercede when subtle changes occur in a patient's condition, to provide medical interventions at the bedside, and/or to transfer the patient to the safest area of the hospital (which may be the intensive care unit ICU) before his or her condition becomes critical.1

So valuable to patient safety is the notion of early intervention through recognition and response to changes in patients' conditions that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) listed it as a proposed National Patient Safety Goal (NPSG) for 2007. Although facility response requirements involving a dedicated RRT were not included in the final 2007 NPSGs, a new requirement to define and communicate a means for patients to report safety concerns was added to goals for patient-centered care. This addition reinforces the importance of adopting processes that empower caregivers to directly request assistance from a designated response team when a patient's condition appears to worsen.

Separately, the Institute for Healthcare Improvement (IHI) a Boston, Massachusetts-based patient safety and quality improvement group, launched its "100,000 Lives Campaign" in 2005 with the goal of saving 100,000 lives annually by enlisting hospitals in the implementation of standardized approaches proven to improve quality and patient safety in hospitals. One of those standardized approaches is the deployment of RRTs.

Citing a global problem of providing necessary interventions to critically ill hospital patients in a timely manner, Michael DeVita, M.D., associate medical director, UPMC Presbyterian Hospital (Pittsburgh, Pennsylvania), told participants at the First International Conference on Medical Emergency Team Responses in 2005 that there should be an RRT in every hospital, everywhere.2 DeVita went on to note during the conference that the RRT...