Abstract 238: Effect of a Rapid Response Team on Cardiopulmonary Arrest Rate at a Veterans Hospital
Introduction: Based on recommendations from multiple health care organizations, rapid response teams (RRT) were widely implemented by hospitals in the United States over the past decade. However, studies have shown variable effects of RRTs on reducing in-hospital mortality. We sought to investigate the effect of the implementation of our RRT on the rate of cardiopulmonary arrests (code 99) at the Atlanta Veterans Affairs Medical Center (VAMC).
Materials and Methods: The RRT started in October 2008 at the Atlanta VAMC. It consists of a respiratory therapist and a registered nurse with at least three years of critical care experience. The medical resident on call is required to participate but is not a primary member of the RRT. Hospital staff and healthcare providers of all medical and surgical non-intensive care units (ICU) were extensively educated about the purpose and role of the RRT. Standard criteria for activating the RRT were placed throughout the hospital. Data of all RRT activations were collected, including reasons for RRT activation, RRT intervention and outcomes. Rate of cardiopulmonary arrests (CPA) during the RRT implementation period (10/2008-9/2010) was compared to a historical control period of 48 months prior to the initiation of the RRT.
Results: During the study period there were 93 activations for the RRT. The most common causes for RRT activation were acute respiratory distress (38.1%) and altered mental status (30.9%). Fifty percent of RRT activation led to a transfer to the ICU and 7.1% converted to cardiopulmonary arrests. Patients for whom the RRT was activated had a 23.8% in-hospital mortality and 58.3% died within two years. There were similar rates of CPA in the pre- and post-RRT era with 46 CPAs in non-ICU wards during the 2-year period of RRT implementation compared to 49 CPAs during the control period (the two years preceding RRT implementation).
Conclusions: Implementation of RRT at the Atlanta VAMC did not reduce hospital wide CPA rate in non-ICU wards. However, RRT activation may be a predictor of illness severity resulting in a higher 2-year mortality rate in predominantly male veterans.
- © 2011 by American Heart Association, Inc.