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"Rapid response teams"

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https://www.readbyqxmd.com/read/29033602/early-in-hospital-clinical-deterioration-is-not-predicted-by-severity-of-illness-functional-status-or-comorbidity
#1
Janice Wang, Stella S Hahn, Myriam Kline, Rubin I Cohen
BACKGROUND: Prior studies concentrated on unplanned intensive care unit (ICU) transfer to gauge deterioration occurring shortly following hospital admission. However, examining only ICU transfers is not ideal since patients could stabilize with treatment, refuse ICU admission, or not require ICU evaluation. To further explore etiologies of early clinical deterioration, we used rapid response team (RRT) activation within 48 hours of admission as an index of early clinical worsening. METHODS: A retrospective analysis of prospectively gathered admissions from the emergency department in an academic medical center was done...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29030935/rapid-response-team-activation-for-pediatric-patients-on-the-acute-pain-service
#2
Maxwell Teets, Dmitry Tumin, Hina Walia, Jenna Stevens, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D Tobias
INTRODUCTION: Untreated pain or overly aggressive pain management may lead to adverse physiologic consequences and activation of the hospital's Rapid Response Team. This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service. METHODS: A retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross-referenced with inpatients requiring consultation from the Rapid Response Team...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29029711/surgical-embolectomy-for-massive-and-submassive-pulmonary-embolism-and-pulmonary-thromboendarterectomy-for-chronic-thromboembolic-pulmonary-hypertension
#3
Richard J Shemin
Surgical therapy for massive acute pulmonary embolism has improved with the use of rapid response teams and selective bedside extracorporeal membrane oxygenation initiation. The chronic consequence of unresolved pulmonary embolism is a treatable form of pulmonary hypertension. Pulmonary thromboendarterectomy is a curative operation in selected cases, operated upon in an experienced center with the multidisciplinary team including imaging, pulmonary medicine, and cardiothoracic surgery.
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28969627/information-needs-for-the-rapid-response-team-electronic-clinical-tool
#4
Amelia Barwise, Sean Caples, Jeffrey Jensen, Brian Pickering, Vitaly Herasevich
BACKGROUND: Information overload in healthcare is dangerous. It can lead to critical errors and delays. During Rapid Response Team (RRT) activations providers must make decisions quickly to rescue patients from physiological deterioration. In order to understand the clinical data required and how best to present that information in electronic systems we aimed to better assess the data needs of providers on the RRT when they respond to an event. METHODS: A web based survey to evaluate clinical data requirements was created and distributed to all RRT providers at our institution...
October 2, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28969166/measles-outbreak-in-the-adolescent-population-matter-of-concern
#5
Priya Rathi, Varun Narendra, Vivek Sathiya, Sanjay Kini, Avinash Kumar, Noore Sana, Rohini, Veena G Kamath
INTRODUCTION: Measles is a disease predominantly seen in young children and infants. It is an unusual occurrence of the disease in the adolescent population warranting an investigation. This would help understand the possible cause-effect relation, changing epidemiology of the disease and immunity gaps to initiate targeted interventional strategies. AIM: To determine the time, place and person distribution of an outbreak and calculate the attack rates and vaccine efficacy...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28935832/an-electronic-trigger-based-on-care-escalation-to-identify-preventable-adverse-events-in-hospitalised-patients
#6
Viraj Bhise, Dean F Sittig, Viralkumar Vaghani, Li Wei, Jessica Baldwin, Hardeep Singh
BACKGROUND: Methods to identify preventable adverse events typically have low yield and efficiency. We refined the methods of Institute of Healthcare Improvement's Global Trigger Tool (GTT) application and leveraged electronic health record (EHR) data to improve detection of preventable adverse events, including diagnostic errors. METHODS: We queried the EHR data repository of a large health system to identify an 'index hospitalization' associated with care escalation (defined as transfer to the intensive care unit (ICU) or initiation of rapid response team (RRT) within 15 days of admission) between March 2010 and August 2015...
September 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#7
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28913951/rapid-response-team-patients-triaged-to-remain-on-ward-despite-deranged-vital-signs-missed-opportunities
#8
J Tirkkonen, T Kontula, S Hoppu
BACKGROUND: Rapid response teams (RRTs) triage most patients to stay on ward, even though some of them have deranged vital signs according to RRTs themselves. We investigated the prevalence and outcome of this RRT patient cohort. METHODS: A prospective observational study was conducted in a Finnish tertiary referral centre, Tampere University Hospital. Data on RRT activations were collected between 1 May 2012 and 30 April 2015. Vital signs of patients triaged to stay on ward without treatment limitations were classified according to objective RRT trigger criteria observed during the reviews...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28885411/improvement-in-outcomes-of-major-obstetric-hemorrhage-through-systematic-change
#9
Daniel W Skupski, David Brady, Isaac P Lowenwirt, Jason Sample, Stephanie N Lin, Rahul Lohana, Gary S Eglinton
OBJECTIVE: To report the outcomes over 14 years of sustained systematic institutional focus on the care of women with major obstetric hemorrhage, defined as estimated blood loss greater than 1,500 mL. METHODS: A retrospective cohort study of women with major obstetric hemorrhage at our hospital from 2000 to 2014 compares baseline conditions (age, multiparity, prior cesarean delivery, morbidly adherent placenta), morbidity (lowest mean temperature, lowest mean pH, coagulopathy, hysterectomy), and mortality among three time periods (period 1=January 2000 to December 2001, period 2=January 2002 to August 2005, period 3=September 2005 to December 2014)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28866971/rapid-response-team-calls-that-overlap-in-time-incidence-consequences-and-patient-outcomes
#10
Arthas Flabouris, Michelle Mesecke
OBJECTIVE: To investigate overlap rapid response team (RRT) calls, factors associated with overlap calls, and their impact on RRT call times and patient outcomes. DESIGN AND SETTING: Review of prospectively collected, linked clinical and administrative datasets, at a public adult tertiary hospital during July 2013 to May 2016. RESULTS: There were 11 669 RRT calls to 7223 patients, of which 10 868 calls (93.1%) were to inpatients. The median number of daily calls was 12 (interquartile range [IQR], 9-15 calls; range, 2-29 calls)...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28851754/implementation-of-a-communication-bundle-for-high-risk-patients
#11
Michelle W Parker, Matthew Carroll, Benjamin Bolser, Janelle Ballinger, John Brewington, Suzanne Campanella, Andrew Davis-Sandfoss, Karen Tucker, Patrick W Brady
BACKGROUND: Interventions that facilitate early identification and management of hospitalized pediatric patients who are at risk for deterioration are associated with decreased mortality. In our large pediatric hospital with a history of success in decreasing unrecognized deterioration, patients at higher risk of deterioration are termed "watchers." Because communication errors often contribute to unrecognized deterioration, clear and timely communication of watcher status to all team members and contingency planning was desired...
September 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28818571/timing-of-palliative-care-team-referrals-for-inpatients-receiving-rapid-response-services-a-retrospective-pilot-study-in-a-us-hospital
#12
M Williams, M Cardona-Morrell, P Stevens, J Bey, M E Smith Glasgow
BACKGROUND/OBJECTIVES: Research indicates up to one-third of rapid response team calls relate to end-of-life symptoms. The CriSTAL criteria were developed as a screening tool to identify high risk of death within three months. The primary purpose of this pilot study was to investigate the timing of palliative care referrals in patients receiving rapid response team services, and patients' CriSTAL criteria score on admission. The potential feasibility of using the CriSTAL tool to stimulate earlier Palliative Care Team (PCT) referral served as an underlying goal, and investigation of a relationship between specific CriSTAL criteria and the prediction of in-hospital death was a secondary objective...
August 8, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28818297/rothman-index-variability-predicts-clinical-deterioration-and-rapid-response-activation
#13
Brian C Wengerter, Kevin Y Pei, David Asuzu, Kimberly A Davis
BACKGROUND: The overall utility of the Rothman Index (RI), a global measure of inpatient acuity, for surgical patients is unclear. We evaluate whether RI variability can predict rapid response team (RRT) activation in surgical patients. METHODS: Surgical patients who underwent RRT activation from 2013 to 2015 were matched to four control cases. RI variability was gauged by maximum minus minimum RI (MMRI) and RI standard deviation (RISD) within a 24-h period before RRT...
August 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28807405/initiation-of-a-multidisciplinary-rapid-response-team-to-massive-and-submassive-pulmonary-embolism
#14
Brett J Carroll, Heather Pemberton, Kenneth A Bauer, Louis M Chu, Jeffrey L Weinstein, Barbara L Levarge, Duane S Pinto
Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE...
October 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28742548/association-between-survival-and-time-of-day-for-rapid-response-team-calls-in-a-national-registry
#15
Matthew Michael Churpek, Dana P Edelson, Ji Yeon Lee, Kyle Carey, Ashley Snyder
OBJECTIVES: Decreased staffing at nighttime is associated with worse outcomes in hospitalized patients. Rapid response teams were developed to decrease preventable harm by providing additional critical care resources to patients with clinical deterioration. We sought to determine whether rapid response team call frequency suffers from decreased utilization at night and how this is associated with patient outcomes. DESIGN: Retrospective analysis of a prospectively collected registry database...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#16
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28687637/inpatient-derived-vital-sign-parameters-implementation-an-initiative-to-decrease-alarm-burden
#17
Alaina K Kipps, Sarah F Poole, Cheryl Slaney, Shannon Feehan, Christopher A Longhurst, Paul J Sharek, Veena V Goel
OBJECTIVES: To implement data-driven vital sign parameters to reduce bedside monitor alarm burden. METHODS: Single-center, quality-improvement initiative with historical controls assessing the impact of age-based, inpatient-derived heart rate (HR) and respiratory rate (RR) parameters on a 20-bed acute care ward that serves primarily pediatric cardiology patients. The primary outcome was the number of alarms per monitored bed day (MBD) with the aim to decrease the alarms per MBD...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28673223/proceedings-of-the-12th-international-conference-on-rapid-response-systems-and-medical-emergency-teams
#18
D Jones, J Holmes, J Currey, E Fugaccia, A J Psirides, M Y Singh, G J Fennessy, K Hillman, D V Pilcher, R Bellomo, M DeVita
Rapid Response Teams (RRTs) have been introduced into hospitals worldwide in an effort to improve the outcomes of deteriorating hospitalised patients. Recently, there has been increased awareness of the need to develop systems other than RRTs for deteriorating patients. In May 2016, the 12th International Conference on Rapid Response Systems and Medical Emergency Teams was held in Melbourne. This represented a collaboration between the newly constituted International Society for Rapid Response Systems (iSRRS) and the Australian and New Zealand Intensive Care Society...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28656602/rapid-response-team-calls-to-obstetric-patients-in-a-busy-quaternary-maternity-hospital
#19
Timothy M Crozier, Pauline Galt, Stuart J Wilson, Euan M Wallace
AIMS: There is limited published information regarding intensive care unit (ICU) led rapid response team (RRT) calls to obstetric patients. We examined the characteristics of RRT calls to obstetric patients at a tertiary teaching hospital. METHODS: Details of calls to pregnant and postpartum patients between October 2010 and June 2014 were obtained from the hospital RRT database. Each was retrospectively examined for data on patient demographics, call trigger, interventions and outcomes...
June 28, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28588996/implementing-one-health-as-an-integrated-approach-to-health-in-rwanda
#20
Thierry Nyatanyi, Michael Wilkes, Haley McDermott, Serge Nzietchueng, Isidore Gafarasi, Antoine Mudakikwa, Jean Felix Kinani, Joseph Rukelibuga, Jared Omolo, Denise Mupfasoni, Adeline Kabeja, Jose Nyamusore, Julius Nziza, Jean Leonard Hakizimana, Julius Kamugisha, Richard Nkunda, Robert Kibuuka, Etienne Rugigana, Paul Farmer, Philip Cotton, Agnes Binagwaho
It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, non-governmental and educational agencies. 'One Health' refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation...
January 2017: BMJ Global Health
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