Improving A Rapid Response System at a Teaching Hospital: Lessons Learned From Implementation of a Novel Performance Self-Evaluation Tool

Abstract

Rapid assessment and treatment (RAT) calls, facilitated by Rapid Response Teams (RRTs), have become vital to the care of hospitalized patients deteriorating outside of the intensive care unit in many institutions worldwide. A significant body of data has recognized the efficacy of rapid response systems (RRSs) in improving patient care; however, there is no standardized protocol that all RRSs practice. Even when the recognition of patient clinical deterioration is rapidly noted, further treatment may be delayed due to issues with clinical knowledge and communication between parties present, especially in training institutions. At our institution in Southern California, the RRT consists of resident physicians supervised by an attending physician, a respiratory therapist, a critical care nurse, and a pharmacist. In our study, we assessed our responses to RAT calls at baseline using a standardized rubric. We then implemented an educational intervention to resident physicians, including clinical and communication components. Finally, we re-assessed our responses to RAT calls post-intervention. We found that an educational intervention improved patient outcomes and several key process measures in our RRS. This article describes the process and lessons learned from our initiative.