Beyond Rapid Response: Instituting a “Rover Team” Improves Management of at Risk Patients, Facilitate Proactive Interventions and Improves Outcomes.

A novel configuration of a traditional rapid response team decreases non–intensive care unit arrests and overall hospital mortality

“…This approach differs from Gerdik et al, who have demonstrated a positive association with the ability of the patient and/or family to activate the RRT. Though similar, our approach also differs from the strategy of a dedicated RRT nurse rounding on “high risk” patients identified through physician and nurse surveys that have also shown a significant reduction in admission deaths . Although the strategies may differ on the specific “team members” initiating the deployment of the RRT, what they appear to have in common is the proactive component of the identification of at‐risk patients.…”

“…27 Though similar, our approach also differs from the strategy of a dedicated RRT nurse rounding on "high risk" patients identified through physician and nurse surveys that have also shown a significant reduction in admission deaths. 26,28,29 Although the strategies may differ on the specific "team members" initiating the deployment of the RRT, what they appear to have in common is the proactive component of the identification of at-risk patients. Additionally, we employ an annual RRT educational seminar for potential primary responders including bedside nurses, respiratory therapists, and physical therapists.…”

The limitations in implementing and operating a rapid response system

“…This may provoke a decreased sense of responsibility on the part of the hospital ward team . Hospital ward teams may be less likely to provide optimal care knowing that there is a backup system of RRS to identify and treat patients if they worsen, even though evidence suggests that being proactive prevents the development of reactive RRT . The presence of RRS may also inadvertently lead to confusion as to who has primary responsibility for the patient …”

Automated detection of physiologic deterioration in hospitalized patients

“…15,16 To be effective, RRS must have an afferent limb (case detection and response triggering) in addition to an efferent limb (medical response) and must be constantly available. 3 Numerous studies describe a variety of characteristics for RRS, [17][18][19][20][21][22][23][24] and some report various abilities to prevent adverse events 1,[25][26][27][28][29][30][31][32][33] while some find no effect. 19,[34][35][36][37][38][39] The controversy regarding the benefits of an RRS centers around the recognition of physiologic deterioration as soon as possible and not just on the medical response.…”