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Education, clinician engagement led to rapid success

Quality Improvement Monitor, August 10, 2007

Don't dive right into setting up a rapid response system without involving the frontline clinicians first, or you could face fierce pushback later on.

So says Charles Arienti, MSM, RRT, director of respiratory services at South Shore Hospital in Weymouth, MA, which launched its rapid response team in September 2006, after six months of planning. "We involved everybody under the sun," says Arienti. Indeed, the multidisciplinary committee included emergency department physicians, intensivists, hospitalists, critical care nurses, nurse managers, respiratory therapists, and the nurses themselves. The group even included a paramedic for advice about the state Department of Public Health emergency medical services protocols.

The 284-bed hospital then set out to educate staff members. The nurses received training in situation, background, assessment, recommendation (SBAR) so they could better communicate their concerns to other clinicians. More than 600 nurses have been trained in SBAR since the rapid response teams began.

"They get right to the point," Arienti says. "They say, 'This is wrong, this is wrong, this is wrong, and this is what's happening. This is my assessment, and these are my recommendations for the care of the patient.' " Part of the training included instructing staff members about respectful behavior toward nurses who call the rapid response team. "We don't want to stifle anybody from ever calling," Arienti says. "We want them to feel supported."

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