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Rapid Response Teams

Patient Safety Quality Monthly, November 19, 2005

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Dear Colleague,

The annual forum of the Institute for Healthcare Improvement (IHI) in Orlando will be held the week of December 12th. If you weren't there last year, you may have missed the beginning of one of the more important efforts in patient safety and quality.

If you aren't aware of the IHI, it's a networking organization started by Dr. Donald Berwick that stimulates hospitals and health delivery organizations to take practical steps to improve patient care. They had over 4000 attendees at the forum last year and another 6000 participating world wide via videoconference. As I suggested previously, if you have never been to their annual forum, you should send at least one person from your organization to check it out.

Each year the forum has a theme. Usually it involves engaging organizations in collaborative efforts to improve some dimension or aspect of patient care. Last year, Dr. Berwick asked the healthcare field to increase the pace of change to breakthrough speed and save 100,000 lives by July, 2006. One of the key tools proposed to make this happen is the Rapid Response Team which I wrote about last year after the IHI meeting.

The Rapid Response Team is not a "Code Blue" team, it is really a code prevention team. There is good evidence that, hours before most cardiorespiratory arrests, many patients exhibit symptoms of change in clinical status that may be below the criteria level for ICU transfer but the bedside nurse has a sense that something is going on. Whenever a bedside nurse has such a concern, the nurse calls a pager number and a team composed of an experienced ICU nurse and a respiratory therapist (and, in some hospitals, either a Physician assistant or an intensivist) comes within 5 minutes. The team works with the bedside nurse to evaluate the patient for either the need to call a physician or for potential transfer to a higher level of care.

Last year, based on the powerful simplicity of this idea and the backing it received from many prominent healthcare systems, I made a prediction that Rapid Response Teams will quickly become an expectation of the various healthcare stakeholders.

So as the first year of the 100,000 Lives Campaign comes to a close, I hope your organization has had chance to implement a Rapid Response Team or at least begin to investigate how you might do so. If you have, please let me know how it is working for you. And if you will be attending the IHI meeting this year, please stop by The Greeley Company/HCPro booth and say hello.

Regards,

Bob Marder, MD
Practice Director, Quality and Patient Safety
The Greeley Company

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