Dealing with the impact of the COVID-19 pandemic on a rapid response team operation in Brazil: Quality in practice

Abstract

Quality problem or issue Up to July 13, 2020, more than 12 million laboratory-confirmed cases of COVID-19 infection have been reported worldwide, 1,864,681 in Brazil. We aimed to assess an intervention to deal with the impact of the COVID19 pandemic on the operations of a rapid response team (RRT). Initial assessment An observational study with medical record review, was carried out at a large tertiary care hospital in Fortaleza, a 400-bed quaternary hospital, 96 of which are ICU beds. All adult patients admitted to hospital wards, treated by the RRTs during the study period, were included, and a total of 15,461 RRT calls were analyzed. Choice of solution Adequacy of workforce sizing. Implementation The hospital adjusted the size of its RRTs during the period, going from 2 to 4 simultaneous on-duty medical professionals. Evaluation After the beginning of the pandemic, the number of treated cases in general went from an average of 30.6 daily calls to 79.2, whereas the extremely critical cases went from 3.5 to 22 on average. In percentages, the extremely critical care cases went from 10.47 to 20%, with p <0.001. Patient mortality remained unchanged. The number of critically-ill cases and the number of treated patients increased two-fold in relation to the pre-pandemic period, but the effectiveness of the RRT in relation to mortality was not affected. Lessons learned The observation of these data is important for hospital managers to adjust the size of their RRTs according to the new scenario, aiming to maintain the intervention effectiveness.

Perception of Global Participants of ITEC Nations on Country's Preparedness and Response to COVID-19 Pandemic

“…Other studies on healthcare workers perspectives to the government response to COVID-19 stated that appropriate infection prevention measures were adopted during the pandemic, like systematic or streamlined supply and use of PPE, and adoption of prevention guidelines ( 43 , 44 ). We observed that in one-third of cases, trained RRTs consisting of health professionals was present in their country while two-third opined the presence of structured use of reporting system, similar to other studies ( 45 – 47 ). The preparedness for the reorganization of the health system in preventing the magnitude of COVID-19 has helped in containing the outbreak through a rapid increase in bed capacity, adequate equipment and staffing, triaging mechanism, and safe delivery of primary care services which is contrary to the current study which scored below average ( 48 – 50 ).…”

Evaluating a novel, integrative dashboard for health professionals’ performance in managing deteriorating patients:quality improvement project

“…We interviewed 3 nurses (2 quality and safety and 1 informatics specialists). Key themes were: (1) participants perceived the dashboard as a facilitator for auditing NEWS2 recording and escalation of care to improve clinicians practice; (2) There is a need for guiding clinicians and adjusting data sources and metrics which could enhance the functionality and usability. From EHR (2019 to 2022) data analysis showed: (1) NEWS2 recording has gradually improved in the implementation and evaluation phases (May 2021 to Apr 2022) from 64% to 83%; (2) Referral and nurses’ assessment forms completion increased (n: 170 to 6800 & 23 to 540, respectively).…”

“…The Covid 19 pandemic has taken its toll on health care services globally. The escalating pressure has significantly raised the surge in deteriorating patients and the need to escalate their care (1). There was an increase in daily tasks for nurses, physicians and rapid response teams to cope with the COVID-19 strain (1).…”

Research of Interdisciplinary Cooperation in the Management of Cardiovascular Emergencies through the Covid-19 Pandemic; A Review of Literature

“…Another observational study reviewing medical records was conducted at a hospital in Fortaleza, Brazil in 2020. [38] A total of 15,461 RRT calls were made during the study period. Since the outbreak of the pandemic, the number of cases treated has risen by an average of 30.6 daily calls to 79.2, while the extremely critical cases have increased from 3.5 to 22.…”