Abstract 11522: Reduction of Cardiac Arrests: The Experience of a Novel Service Centric Rapid Response Team
Background: The impact of rapid response teams (RRTs) on number of cardiac arrests (CAs) is unclear. We hypothesize that a novel, service centric (SC), budget neutral RRT model can impact the incidence of CA by bringing critical care expertise to the bedside of a deteriorating patient. The SC RRT model includes a medical provider from the medical/surgical service to which the patient is admitted (cardiology, medicine, general surgery, etc.), a critical care RN and a respiratory therapist.
Methods: A retrospective analysis was performed on prospectively collected data on adults in a 867-bed tertiary care hospital for the years 2007 to 2012. The SC RRT program started on 12/23/2007 in Cardiology and expanded hospital wide during 2008/2009, maturing at 10 teams. CA rate was adjusted for hospital care days. Pairwise comparisons of CA rate between 3-time periods were performed for ICU, Non-ICU and combined ICU/Non-ICU patients.
Results: Of the total 1,140,233 hospital care days analyzed from 2007 through 2012, 745 patients had CA. The overall CA rate was significantly higher in 2007 than in 2008/09 and 2010/12 (0.84 vs 0.59 and 0.84 vs 0.64 per 1000 care days, p<0.001 and p=0.003, respectively); no difference was detected between 2008/09 and 2010/11. CA rate in the ICU was significantly higher in 2007 than in 2008/09 and 2010/12 (3.96 vs 2.14 and 3.96 vs 2.68 per 1000 care days, p<0.001 and p<0.001, respectively); there was no difference between the later two-year groups. A significant difference was detected between 2007 and 2010/12 (0.46 vs 0.35 per 1000 care days, p=0.046) for non-ICU units (Figure 1).
Conclusions: A novel budget neutral service centric RRT program is associated with a reduction in the overall incidence of CAs in both ICUs and non-ICUs. A potential explanation for these observations is earlier intervention in the care of unstable patients by an expanded group of expert caregivers.
- © 2013 by American Heart Association, Inc.