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"Rapid Response Team*"

Muhammad Yousaf, Sheher Bano, Muhammad Attaur-Rehman, Chaudhary Muhammad Junaid Nazar, Aayesha Qadeer, Salma Khudaidad, Syed Waqar Hussain
Objective To compare hospital-wide code rates and mortality before and after the implementation of a rapid response team (RRT). Study design A prospective cohort design with historical controls. Place of study This study was conducted at Shifa International Hospital, Islamabad, from January 21, 2016, to January 20, 2017. Materials and methods The triggers for the rapid response team (RRT) were displayed on each floor. The in-house staff was trained on when and how to activate the rapid response team (RRT). Data were collected on a specified data collection form...
January 9, 2018: Curēus
Lindsay L Juriga, David J Murray, John R Boulet, James J Fehr
BACKGROUND: Simulation is frequently used to recreate many of the crises encountered in patient care settings. Teams learn to manage these crises in an environment that maximizes their learning experiences and eliminates the potential for patient harm. By designing simulation scenarios that include conditions associated with diagnostic errors, teams can experience how their decisions can lead to errors. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error...
November 27, 2017: Diagnosis
Shannon M Fernando, Peter M Reardon, Sean M Bagshaw, Damon C Scales, Kyle Murphy, Jennifer Shen, Peter Tanuseputro, Daren K Heyland, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) are groups of healthcare providers that are used by many hospitals to respond to acutely deteriorating patients admitted to the wards. We sought to identify outcomes of patients assessed by RRTs outside standard working hours. METHODS: We used a prospectively collected registry from two hospitals within a single tertiary care-level hospital system between May 1, 2012, and May 31, 2016. Patient information, outcomes, and RRT activation information were stored in the hospital data warehouse...
March 14, 2018: Critical Care: the Official Journal of the Critical Care Forum
Susan K Fried
No abstract text is available yet for this article.
March 13, 2018: Journal of Leukocyte Biology
Nikoleta S Kolovos, Jeff Gill, Peter H Michelson, Allan Doctor, Mary E Hartman
OBJECTIVE: To evaluate the effectiveness of a physician-led rapid response team program on morbidity and mortality following unplanned admission to the PICU. DESIGN: Before-after study. SETTING: Single-center quaternary-referral PICU. PATIENTS: All unplanned PICU admissions from the ward from 2005 to 2011. INTERVENTIONS: The dataset was divided into pre- and post-rapid response team groups for comparison...
March 9, 2018: Pediatric Critical Care Medicine
Michael K Xu, Kathleen G Dobson, Lehana Thabane, Alison E Fox-Robichaud
BACKGROUND: Rapid response teams have been widely adopted across the world. Although evidence for their efficacy is not clear, they remain a popular means to detect and react to patient deterioration. This may in part be due to there being no standardized approach to their usage or implementation. A key component of their ability to be effective is the speed of response. OBJECTIVE: The objective of this review is to evaluate the effect of delayed response by rapid response teams on hospital mortality (primary), cardiac arrest, and intensive care transfer rates (secondary)...
March 9, 2018: Systematic Reviews
Joonas Tirkkonen, Heini Huhtala, Sanna Hoppu
AIM: Study the incidence and reasons behind in-hospital cardiac arrests (IHCAs) after rapid response team (RRT) reviews. METHODS: We conducted a matched case-control study at Tampere University Hospital, Finland. Data on adult patients who were triaged to remain on general ward after first (index) RRT review without treatment limitations but who suffered an IHCA within the following 48 hours were prospectively collected for 5.3 years. These cases were matched (age +/- 3 years, sex, surgical/medical ward, admission year) at a 1:4 ratio to controls (no ICHA after RRT review)...
March 6, 2018: Resuscitation
Tessa L Walters, T Edward Kim, Edward R Mariano, Geoffrey Kenton Lighthall
BACKGROUND: The Perioperative Surgical Home (PSH) is an anesthesiologist-led, coordinated care model that may improve patient experience and safety. We hypothesized that PSH will decrease activation of the rapid response system for surgical inpatients. METHODS: This retrospective study was performed at an academic Veterans Affairs hospital with a PSH. Data from both medical and surgical cohorts admitted to a single ward were analyzed for the Pre-PSH (July 2006 to October 2010) and Post-PSH (November 2011 to May 2015) epochs...
March 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Jonathan Rubin, Cristhian Potes, Minnan Xu-Wilson, Junzi Dong, Asif Rahman, Hiep Nguyen, David Moromisato
BACKGROUND: Early deterioration indicators have the potential to alert hospital care staff in advance of adverse events, such as patients requiring an increased level of care, or the need for rapid response teams to be called. Our work focuses on the problem of predicting the transfer of pediatric patients from the general ward of a hospital to the pediatric intensive care unit. OBJECTIVES: The development of a data-driven pediatric early deterioration indicator for use by clinicians with the purpose of predicting encounters where transfer from the general ward to the PICU is likely...
April 2018: International Journal of Medical Informatics
Mark Romig, Jordan Duval-Arnould, Bradford D Winters, Heather Newton, Adam Sapirstein
To better support the highest function of the Johns Hopkins Hospital adult code and rapid response teams, a team leadership role was created for a faculty intensivist, with the intention to integrate improve processes of care delivery, documentation, and decision-making. This article examines process and outcomes associated with the introduction of this role. It demonstrates that an intensivist has the potential to improve patient care while offsetting costs through improved billing capture.
April 2018: Critical Care Clinics
Tammy Ju, Mustafa Al-Mashat, Lisbi Rivas, Babak Sarani
Sepsis rapid response teams are being incorporated into hospitals around the world. Based on the concept of the medical emergency team, the sepsis rapid response team consists of a specifically trained team of health care providers educated in the early recognition, diagnosis, and treatment of patients at risk of having or who have sepsis. Using hospital-wide initiatives consisting of multidisciplinary education, training, and specific resource utilization, such teams have been found to improve patient outcomes...
April 2018: Critical Care Clinics
Patricia L Dalby, Gabriella Gosman
An obstetric-specific crisis team allows institutions to optimize the care response for patients with emergent maternal or fetal needs. Characteristics of optimal obstetric rapid response teams are team member role designations; streamlined communication; prompt access to resources; ongoing education, rehearsal, and training; and continual team quality analysis. The outcomes must be incorporated into team responses and reinforced in training. Team response provides a key resource to reassure staff, physicians, and patients that prompt crisis care is only a single call away...
April 2018: Critical Care Clinics
Alexandra Briggs, Andrew B Peitzman
Failure to rescue is death occurring after a complication. Rapid response teams developed as a prompt intervention for patients with early clinical deterioration, generally from medical conditions or complications. Patients with surgical complications or surgical pathology require prompt evaluation and management by surgeons to avoid deterioration; this is surgical rescue. Patients in the medical intensive care unit may develop intra-abdominal pathology that requires expeditious operative intervention. Acute care surgeons should serve as the surgical rapid response team to help assess and manage these complex patients...
April 2018: Critical Care Clinics
Kim Moi Wong Lama, Michael A DeVita
Electronic medical records can be used to mine clinical data (big data), providing automated analysis during patient care. This article describes the source and potential impact of big data analysis on risk stratification and early detection of deterioration. It compares use of big data analysis with existing methods of identifying at-risk patients who require rapid response. Aggregate weighted scoring systems combined with big data analysis offer an opportunity to detect clinical changes that precede rapid response team activation...
April 2018: Critical Care Clinics
Teddie Tanguay, Reagan Bartel
In early 2010, the Royal Alexandra Hospital (RAH) was the only tertiary hospital in Edmonton, Alberta, without a rapid response team (RRT). Once funding was obtained, the RAH RRT was developed with the mission of "Helping you make it happen" with the underlying philosophy that any call is a good call and the team is there to support care on the wards. The RAH RRT is unique, as it uses a registered nurse/respiratory therapist model rather than the physician model used by most tertiary centres. The RAH RRT provides consistent and efficient response to deteriorating patients and visitors to the hospital...
May 2017: Canadian Journal of Critical Care Nursing
Bharathy Gunasekaran, Jennifer Weil, Tom Whelan, John Santamaria, Mark Boughey
Opioid prescriptions have significantly increased in recent years and are used for a wide variety of indications. Electronic medical records of 45 patients who received naloxone by a rapid response team over an 18-month period were retrospectively reviewed. This study found inconsistencies in the management of possible opioid toxicity with variation in the total naloxone dose and number of doses administered. This highlights the importance of a standardised protocol for recognition and management of opioid overdose...
February 2018: Internal Medicine Journal
Frank Sebat, Mary Anne Vandegrift, Sid Childers, Geoffrey K Lighthall
BACKGROUND: Rapid response systems (RRSs) have been universally adopted in much of the developed world; yet, despite broad implementation, their success has often been limited. Even with successful systems, there is a small body of evidence regarding effective organizational elements that are responsible for improved outcomes. New organizational processes were implemented that restructured the existing RRS, and the impact on the number of rapid response team (RRT) alerts, cardiac arrest, and mortality rates was evaluated...
February 2018: Joint Commission Journal on Quality and Patient Safety
Daniel Schwarzkopf, Hendrik Rüddel, Matthias Gründling, Christian Putensen, Konrad Reinhart
BACKGROUND: While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany...
January 18, 2018: Implementation Science: IS
Purujit J Thacker, Mansha Sethi, Jonathan Sternlieb, Doron Schneider, Mary Naglak, Rajeshkumar R Patel
OBJECTIVES: The aims of the study were the following: (1) to determine how often computed tomography (CT) scans of the head are obtained on rapid responses called for altered mental status (AMS), (2) to determine whether CT imaging of the head is required during all rapid responses called for AMS, (3) to determine which patients would benefit from CT scans of the head in this setting, (4) to note whether an adequate neurologic exam was documented, (5) to determine the cost of CT scans that did not change management, and (6) to examine the role of medications leading to AMS...
January 17, 2018: Journal of Patient Safety
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
April 2018: Current Opinion in Anaesthesiology
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