Abstract 269: A “Front-Loaded” Rapid Response Team Decreases Non-ICU Arrests and Overall Hospital Mortality
Background: In-hospital cardiopulmonary arrest (CPA) is characterized by progressive hypoxemia and hypotension leading to bradyasystole. Rapid response teams (RRTs) are designed to prevent non-ICU CPA through early detection and therapeutic intervention. However, existing evidence has not consistently demonstrated benefit to RRT programs.
Objective: To explore the effectiveness of a “front-loaded” RRT program to decrease non-ICU CPA and overall hospital mortality.
Methods: This study was conducted in two urban university hospitals from 2005 to 2011. In 2007, our hospitals implemented RRT as part of the Advanced Resuscitation Training (ART) program. Our RRT program is “front-loaded” in that charge nurses from each inpatient unit undergo training as RRT members, and all inpatient staff receive annual training in RRT concepts. To evaluate overall effectiveness of RRT, we compared the incidence of non-ICU CPA (per 1,000 patient discharges) before and after program implementation. The incidence of ICU CPA as well as overall hospital mortality were also reported. In addition, the overall number of RRT versus code blue activations for each individual inpatient unit were compared using linear regression. Finally, the annual change in RRT versus code blue activations for each inpatient unit were also compared.
Results: A total of 546 CPAs were observed from 2005-11; a total of 725 RRT activations were observed from 2007-11. The incidence of non-ICU CPA decreased while the incidence of ICU CPA remained unchanged follow RRT program implementation. Overall hospital mortality also decreased over the study period (2.12% to 1.74%, p<0.001). Inpatient units with a greater number of code blue activations also had more RRT activations (r=0.17, p=0.242). However, units with a year-over-year increase in RRT activations experienced a decrease in code blue activations, while units with a decrease in RRT activations experienced an increase in code blue activations (r=-0.68, p<0.001).
Conclusion: A front-loaded RRT program decreases the incidence of non-ICU CPA and overall hospital mortality.
- © 2011 by American Heart Association, Inc.