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Rapid response team

Sarah T Ward, Justin B Dimick, Wenying Zhang, Darrell A Campbell, Amir A Ghaferi
OBJECTIVE: To identify hospital staffing models associated with failure to rescue (FTR) rates at low- and high-performing hospitals. BACKGROUND: FTR is an important quality measure in surgical safety and is a metric that hospitals are seeking to improve. Specific unit-level determinants of FTR, however, remain unknown. METHODS: Retrospective, observational study using data from the Michigan Quality Surgical Collaborative, which is a prospectively collected and clinically audited database in the state of Michigan...
March 19, 2018: Annals of Surgery
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
Maria Lucia Specchia, Giuseppe La Torre, Giovanna Elisa Calabrò, Paolo Villari, Roberto Grilli, Antonio Federici, Walter Ricciardi, Chiara de Waure
Background: The current economic context calls for rationalizing health resources that can be pursued through disinvestment from low value health technologies to invest in the best performing ones, ensuring high healthcare quality. Oncology is a field where, because of high costs of health technologies and rapid innovation, disinvestment is crucial. Methods: On this basis, the research team investigated through a survey, based on a questionnaire, opinions and views of representatives of European countries about disinvestment, in terms of fields of application, potential advocates and barriers, specifically focusing on cancer care...
March 12, 2018: European Journal of Public Health
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
Takeshi Yamamoto
High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status...
2018: Journal of Intensive Care
Alan R Clough, Kristy Grant, Jan Robertson, Matthew Wrigley, Nina Nichols, Tracey Fitzgibbon
INTRODUCTION: Rates of secondhand smoke exposure are currently significantly higher among remote indigenous communities in the top end of Australia. By implementing a 'smoke-free home' rule, secondhand smoke exposure can be reduced. Smoke-free homes encourage quit attempts and improve the health of children. The prevalence of indigenous smoking rates in remote, discrete communities in Australia is elevated compared with their non-indigenous counterparts. The primary aim of this project is to examine the feasibility of conducting a health-driven intervention to encourage community members to make their homes a smoke-free zone...
March 2, 2018: BMJ Open
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
Carlos Suso-Ribera, Ángela Mesas, Javier Medel, Anna Server, Esther Márquez, Diana Castilla, Irene Zaragozá, Azucena García-Palacios
BACKGROUND: Chronic pain has become a major health problem across the world, especially in older adults. Unfortunately, the effectiveness of medical interventions is modest. Some have argued that assessment strategies should be improved if the impact of medical interventions is to be improved. Ecological momentary assessment using smartphones is now considered the gold standard in monitoring in health settings, including chronic pain. However, to the best of our knowledge, there is no randomized controlled trial to show that telemonitoring using a smartphone app can indeed improve the effectiveness of medical treatments in adults with chronic pain...
February 27, 2018: Trials
Adam Cheng, Angelo Mikrogianakis
Resuscitation and cardiac arrest events in the paediatric population are rare occurrences. Improving outcomes from such events continues to be a difficult challenge. Rapid response systems and teams have been integrated into many hospitals in an effort to facilitate early identification and management of patients at risk for clinical deterioration. Optimizing education in the form of team training is a major component of successful team performance. Simulation-based team training, is a key educational supplement for existing standardized resuscitation courses...
February 2018: Paediatrics & Child Health
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