Comparison of Hospital-Wide Code Rates and Mortality Before and After the Implementation of a Rapid Response Team

Yousaf, Muhammad; Bano, Sheher; Attaur-Rehman, Muhammad; Nazar, Chaudhary Muhammad Junaid; Qadeer, Aayesha; Khudaidad, Salma; Hussain, Syed Waqar

doi:10.7759/cureus.2043

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…The analysis mentioned above demonstrated that RRT was most frequently called to assess respiratory efficiency (Figure 1), which is consistent with the observations of some authors who found that the major cause of calls was respiratory disorders [5] and that the main procedure carried out was endotracheal intubation [6]. According to some other authors, however, the most common causes of calls included concerns about the patient condition [6], general bad condition of patients [7], rapid neurological changes [8][9][10]. The most common pharmacotherapy, as disclosed by the analysis, was a change or continuation of the hitherto applied antibiotic therapy, administration of vasopressors and fluid therapy, which is also in agreement with the study findings reported by other authors [5,6].…”

supporting

confidence: 85%

“…Analysis of RRT interventions and evaluation of their effectiveness have been recently studied only in foreign centres, where the RRT counterparts (of different names) have been functioning for a long time [5][6][7][8][9][10]. Since RRTs were introduced in Poland only in 2018, the reports assessing their effectiveness in Poland are lacking.…”

mentioning

confidence: 99%

“…Likewise, the reports from foreign centres have also demonstrated reduced numbers of hospital SCA as well as unexpected deaths after the introduction of RRTs [11,12]. A few papers available in literature have not shown the effects of RRTs on a reduction in numbers of hospital SCA [4] or that their reduction was not statistically significant [10]. Moreover, the implementation of RRTs according to the concept of ICU without walls, which aims at intensification of treatment in the department that admitted the patient (outside ICU), without need for ICU admission, reduced the number of intra-hospital transfers of patients to ICU by 29.2% (Table 3).…”

mentioning

confidence: 99%

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Effects of introducing a rapid response team in a university teaching hospital – preliminary analysis

Czempik

Kapłan

Krok

et al. 2019

ait

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supporting

confidence: 85%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of introducing a rapid response team in a university teaching hospital – preliminary analysis

Czempik

Kapłan

Krok

et al. 2019

ait

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“…Over the past two decades, RRT has been implemented in many secondary or tertiary hospitals in the belief that early detection and timely management of at-risk patients will improve hospital outcomes [10][11][12]. Several recent studies have demonstrated this belief by showing that RRT could help reduce in-hospital mortality rates [13][14][15][16][17][18]. In addition, RRT implementation has been shown to improve the adherence to the sepsis bundle in HOS [9].…”

Section: Introductionmentioning

confidence: 99%

Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study

et al. 2022

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Background Hospital-onset sepsis is associated with a higher in-hospital mortality rate than community-onset sepsis. Many hospitals have implemented rapid response teams (RRTs) for early detection and timely management of at-risk hospitalized patients. However, the effectiveness of an all-day RRT over a non-all-day RRT in reducing the risk of in-hospital mortality in patient with hospital-onset sepsis is unclear. We aimed to determine the effect of the RRT’s operating hours on in-hospital mortality in inpatient patients with sepsis. Methods We conducted a nationwide cohort study of adult patients with hospital-onset sepsis prospectively collected from the Korean Sepsis Alliance (KSA) Database from 16 tertiary referral or university-affiliated hospitals in South Korea between September of 2019 and February of 2020. RRT was implemented in 11 hospitals, of which 5 (45.5%) operated 24-h RRT (all-day RRT) and the remaining 6 (54.5%) had part-day RRT (non-all-day RRT). The primary outcome was in-hospital mortality between the two groups. Results Of the 405 patients with hospital-onset sepsis, 206 (50.9%) were admitted to hospitals operating all-day RRT, whereas 199 (49.1%) were hospitalized in hospitals with non-all-day RRT. A total of 73 of the 206 patients in the all-day group (35.4%) and 85 of the 199 patients in the non-all-day group (42.7%) died in the hospital ( P = 0.133). After adjustments for co-variables, the implementation of all-day RRT was associated with a significant reduction in in-hospital mortality (adjusted odds ratio 0.57; 95% confidence interval 0.35–0.93; P = 0.024). Conclusions In comparison with non-all-day RRTs, the availability of all-day RRTs was associated with reduced in-hospital mortality among patients with hospital-onset sepsis. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-04149-z.

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“…5 Other studies have failed to show an effect of RRS implementation on these outcomes. 6,7 Overall, there is moderate quality evidence that suggests that RRSs decrease rates of cardiac arrest outside the ICU and in-hospital mortality, but the mechanisms of improvement are not clear.…”

mentioning

confidence: 99%

Using the National Incident Management System to Prepare Physicians for Rapid Responses: A Pilot Study

Bar

Symonds

Pont

et al. 2022

Disaster med. public health prep.

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Objective: The study objective was to determine the feasibility of training physicians in the principles of the National Incident Management System (NIMS) and Incident Command System (ICS) as applied to in-hospital rapid responses and to assess physicians’ attitudes regarding rapid responses. Methods: This was an educational pilot study. Resident physicians completed a pre-survey, followed by online training in the principles of NIMS and ICS, a knowledge test, and a post-survey. Results: The number of residents who participated was 22. In the pre-survey, most (20/22) did not have a working understanding of NIMS/ICS. Participants (21/22) agreed that residents should have more training in resource organization. On the knowledge test, the median score was 9.5/10. In the post-survey, participants felt more comfortable clearing extra resources from the scene (P < 0.001) and that it would be easier to keep track of resources (P < 0.001). Most indicated that they had a working understanding of NIMS/ICS (P < 0.001) and felt more comfortable establishing command using NIMS/ICS (P < 0.001). All agreed that they would consider using an NIMS/ICS-based structure on their next rapid response. Conclusions: Training physicians in the principles of NIMS/ICS as they pertain to rapid responses is feasible and appears to change residents’ attitudes about rapid responses.

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Comparison of Hospital-Wide Code Rates and Mortality Before and After the Implementation of a Rapid Response Team

Cited by 7 publications

References 12 publications

Effects of introducing a rapid response team in a university teaching hospital – preliminary analysis

Effects of introducing a rapid response team in a university teaching hospital – preliminary analysis

Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study

Using the National Incident Management System to Prepare Physicians for Rapid Responses: A Pilot Study

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