Comparison of Two Rapid Response Teams Models

Abstract

Background . Although rapid response teams (RRTs) decrease in-house cardiac arrests, signifi cant debate exists surrounding their impact on patient outcomes. We have implemented the continuum of care (CoC) model for the surgical services in our center as a novel approach to patient care. Methods . This study was designed to assess the utilization of RRT resources and cardiac arrests between RRT and CoC coverage. Results . Whereas hospital-wide RRT activations increased in incidence from 2007 to 2010 by 45%, CoC patients experienced steadily decreasing percentage of total RRT activations. Rapid response triggers that led to cardiac arrest under the CoC were 8% in comparison with 17% in the control group. Non-CoC model/RRT activations increased dramatically from 0.3% to 1.5% of total admissions over 4 years whereas CoC RRT activation rates minimally increased from 0.3% to 0.4% (events per total admission per year). Cardiac arrests occurred in 0.4% of non-CoC patients while only occurring in 0.03% of CoC patients, P < .0001. Conclusion . The implementation of the CoC model reduces events requiring RRT activations, preserves continuity of care by closely following high-risk patients, and reduces cardiac arrests via proactive intervention by critical care specialists.