Clinical Workflows Supported by Patient Care Device Data
John R. Zaleski in Clinical Surveillance, 2020
Responding to adverse patient events has given rise to a collaborative clinical team that is focused on preventing further deterioration in patients in whom emergent conditions such as sepsis have arisen. The concept of the Rapid Response Team (RRT) was introduced in hospitals throughout the United States and Europe as a means of intervening in patient decline and decompensation prior to the onset of a mortal adverse event for which there is a risk associated with failure to rescue (FTR).* Key measures for the early onset warnings that trigger the deployment of such teams include changes in vital signs that may herald the onset of possibly irreversible cardiac, neurologic, or respiratory deterioration in patients, resulting in the potential for “failure to rescue” in the case of adverse events.
Avoiding hospital admission
Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay in COPD in Primary Care, 2018
As a result, a new service model was developed, referred to as intermediate care, which includes the following: a rapid response team in the community or in the Accident and Emergency departmentan early discharge schemeshort-term rehabilitation within residential care or the patient’s own homehospital at homecommunity matron input on a regular basis.
Minimising crisis points in paediatric palliative care: the ACT care pathways in action
Rita Pfund, Susan Fowler-Kerry, Sister Frances Dominica in Perspectives on Palliative Care for Children and Young People, 2017
There is a risk that the death of a child with a life-limiting or a life-threatening condition will be inappropriately investigated. Local safeguarding boards have put systems in place to alert the rapid response team when a child dies. Ambulance staff may be under instruction to take the body of any child found dead at home to the hospital emergency department for post mortem examination and the place of death may be made a crime scene. A personal resuscitation plan in the home provides written confirmation that the child is at risk of a life-threatening event, plus contact details to allow rapid liaison with the child’s palliative care team. This should help avoid inappropriate activation of the rapid response team.
Pediatric rapid response system innovations
Published in Hospital Practice, 2021
Lindsey Troy, Mary Burch, Jonathan G. Sawicki, Jared W. Henricksen
The term Rapid Response System (RRS) refers to a hospital-based system for responding to patients who are in a non-critical care setting and are experiencing a deterioration requiring escalation of care [8]. Ultimately, the goal of an RRS is twofold: early identification of a physiologic deterioration and early intervention with optimal resources and personnel. When a patient’s clinical condition exceeds the resources available for the acute care team to intervene to prevent respiratory or cardiac arrest, the patient is experiencing a ‘critically unbalanced resource-to-needs situation’ [8]. This imbalance between patient needs and unit resources can be in the form of specialized equipment, medications, staffing, intensive care expertise, or physiologic monitoring. A rapid response system is designed to bring the resources and personnel of a critical care team to the patient’s location during times of decompensation.
Best practices in pediatric sepsis: building and sustaining an evidence-based pediatric sepsis quality improvement program
Published in Hospital Practice, 2021
Jennifer K. Workman, Amber Chambers, Christopher Miller, Gitte Y. Larsen, Roni D. Lane
The second major challenge was variability in provider coverage across different services. While the pediatric hospitalist and general surgery teams have in-house coverage 24/7, many of the other inpatient teams do not, particularly at night. Our protocol requires a patient to be evaluated by a provider within 10 minutes of an alert activation, which includes the attending of record. For the teams who are not able to respond in this time frame, the protocol recommends a Rapid Response activation. Utilizing the rapid response system facilitates timely evaluation and treatment of potential sepsis patients. After a year of utilizing the sepsis screening and treatment guidelines, we have gained significant sepsis awareness among the Medical/Surgical caregivers, driving earlier sepsis recognition.
The Role of Canadian respiratory therapists in adult critical care (ICURT-CAN): A scoping review
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2023
Shirley Quach, Marco Zaccagnini, Tara L. Packham, Roger Goldstein, Dina Brooks
RTs were commonly included in extended critical care teams, either as part of the rapid response or tracheostomy care team. The rapid response team, synonymous to the medical emergency team or critical care outreach, was described as a team of interdisciplinary clinicians with critical care experience to respond to critically ill and deteriorating patients in the hospital, outside of the ICU.87 The rapid response team model was introduced in the late 2000s at the First consensus meeting on Medical Emergency Teams,87 and endorsed by the Canadian Patient Safety Institute in 2009, who recommended including RTs as part of the team.76 This may explain the interest in evaluating the RT role in the rapid response team in various quality improvement projects published between 2008 to 2018.51,52,54,55 Although these studies did not explicitly evaluate RTs’ impact on patient outcomes, collaborative implementation of these interprofessional teams showed benefits.51,55 For example, the extended critical care team (consisted of critical care nurse, RT and intensivist) at the Ottawa Hospital showed improved patient severity scores, decreased cardiac arrests and ICU admissions (all p < 0.01).51 Similarly, in a continuous quality improvement project in four regional hospitals of Interior Health, British Columbia, the High Acuity Response team (HART) included RTs for transports, saving staffing resources in community hospitals.54 For studies evaluating tracheostomy teams with integrated RT members, these teams were shown to decrease the time to SLP referral, first tracheostomy tube change, increased use of speaking valves and reduced complication rates.27,29
Related Knowledge Centers
- Cardiac Arrest
- Respiratory Arrest
- Vital Signs
- Tachypnea
- Hospital
- Early Warning Score
- Pediatrics
- Nursing
- Respiratory Therapist
- Cost-Effectiveness Analysis