Team Of Nurses Research Articles

A multidisciplinary safety briefing for acutely ill and deteriorating patients: A quality improvement project

BackgroundSafety briefings can help promoting situational awareness, interprofessional communication and improve patient safety. Local problemA clinical survey highlighted that 90% of the participants including the medical team and the critical care outreach team nurses perceived the meeting for escalating acutely ill and deteriorating patients during the out-of-hours period (20.00 to 08.00) to have unconstructive and unwelcoming atmosphere with belittling, hostility and unhelpful criticisms. The participants reported that the communication across teams lacked in structure and clear information given; but staff also self-reported lacking confidence in communicating key issues. MethodA quality improvement project with Plan-Do-Study-Act was adopted to design and implement a dedicated multidisciplinary safety briefing with a structured format. ResultsThe multidisciplinary safety briefing was to 90% of clinicians, and it took a median of 10 min to complete. Delayed referrals to the critical care outreach team were reduced by 46%. Positive changes included increased situational awareness and clearer communication across teams. Barriers identified were variable usage and need for face-to-face presence. Considering all the findings and the time constraint during the SARS-CoV-2 pandemic, we changed to a telephonic safety briefing directly to the team leaders. ConclusionA structured multidisciplinary safety briefing can improve patient safety and support management of deteriorating and acutely ill patients on the wards during the out-of-hours period.

Creation of standard work for the management of outpatient oral antineoplastic therapy.

369 Background: Recently, there has been a dramatic increase in the use of oral antineoplastics for the treatment of various malignancies. The development of these agents has been so rapid that the infrastructure needed for their appropriate supervision has trailed their availability. Previously at Virginia Mason, there was no standard work established for the management of patients starting these agents and consequently there were defects noted, including delays in the medications’ delivery to the patient, lack of appropriate teaching regarding potential medication toxicities and even delayed provider follow-up. The goal of this project was to create standard work around the treatment initiation and follow-up of all patients starting outpatient oral antineoplastic therapy. Methods: A multi-disciplinary team of providers, nurses, and pharmacists held a flow mapping session to identify defects and waste points in the process between the prescription being written until the first provider follow-up visit after medication delivery. The team focused on decreasing the amount of time between prescription initiation and first clinic follow up, as well as increasing the percentage of RN teaching sessions performed and documented. This involved the creation of a dedicated inbox in the Electronic Medical Record (EMR) to which pharmacy and care manager nurses had exclusive access to facilitate rapid communication between team members. The work also resulted in the creation of an antineoplastics teaching template which was used to document teaching on potential treatment toxicities. Results: Standard work was created for the outpatient oral antineoplastic administration process and teaching documentation. Using the new tools, lead time was improved by 21.7% and teaching documentation was improved by 185% at the 30-day mark. These metrics were monitored over a 3 month period, and at the end of 90 days the lead time improvement was maintained at 21.2% and teaching documentation improvement at 110% (Table). Conclusions: The rapid development of oral antineoplastic medications has required Oncology practices to develop more robust workflow infrastructure to administer these medications properly and safely. We created standard work for the proper initiation and follow-up of oral antineoplastic therapy. In doing so we identified specific defects and instances of waste and were able to improve the workflow process to address these issues, resulting in measurable quality improvements and overall better patient care.[Table: see text]

Implementation of a proactive outreach program to patients with gastrointestinal malignancies starting new chemotherapy regimens.

340 Background: Gastrointestinal oncology patients (GIOP) at Fox Chase Cancer Center (FCCC) disproportionately require emergency department (ED) or urgent care (UC) evaluation due to chemotherapy-related adverse events (CRAE). Between January 2014 - June 2018, GIOP comprised 24% of visits to the FCCC ED and 29% of visits to the FCCC UC center, though specific patient and disease characteristics are unavailable. Prior to March 2022 there was no process to proactively contact patients to assess for CRAE or provide symptom management education (SME) following the administration of a new intravenous chemotherapy (IVC). This contributed to a perception of higher volumes of patient-initiated phone calls for acute CRAE management, SME, and UC/ED evaluations as compared to other disease sites, leading to patient and provider dissatisfaction. Methods: We aimed to contact at least 50% of all GIOP starting new IVC through a standardized nurse-initiated phone call within 72 hours of a patient’s first infusion by June 2022. A multidisciplinary team of medical oncology fellows, nurses, and clinic managers launched this initiative through participation in the ASCO Quality Training Program. A series of Plan-Do-Study-Act (PDSA) cycles were conducted over 12 weeks. All GIOP starting a new IVC were electronically identified on a weekly basis by the infusion room scheduling system. Clinic nurses called patients from this list to assess symptoms, provide SME, and advise early intervention for CRAE. A smart phrase was developed for efficient yet comprehensive documentation in the electronic medical record (EMR). EMR documentation was reviewed weekly to determine if calls were made within 72 hours of treatment, which guided subsequent PDSA cycles. Results: From March 14, 2022 to June 3, 2022, a list of all GIOP starting a new IVC was generated and consistently distributed weekly to nurses embedded in 6 GI oncology clinics. Over 12 weeks, 40 (56%) of 71 patients receiving a new IVC were called and 37 (52%) of the patients were called within 72 hours. Of the patients who were called, 93% were called within the intended time frame. Nurses documented their outreach calls in the EMR utilizing a standardized smart phrase to summarize CRAE assessments and SME. Acute or unresolved issues were triaged to the patient’s primary oncology team for further guidance. Conclusions: This initiative successfully introduced a nursing-led outreach phone call to GIOP starting a new IVC, though additional PDSA cycles are needed to achieve more consistent outreach. We plan to standardize outreach to patients with organized SME while striving to automate performance monitoring. Further evaluation of this intervention, which will eventually better identify patients at highest risk for acute unplanned care needs, will assess the impact of patient-reported outcomes and health care utilization.

Non-shortened length of hospital stay despite high compliance rate to colorectal Enhanced Recovery After Surgery (ERAS) protocol in a middle-income country

Objectives: ERAS is a multimodal, multidisciplinary approach to the care of the patient undergoing surgery that includes a team of surgeons, anesthesiologists, nurses, and patient care staff. ERAS programs include essential elements such as targeted fluid management, avoidance of drains and tubes, effective pain control, early mobilization, and promotion of early enteral feeding. ERAS started primarily with colorectal surgery but has been shown to improve outcomes in all major surgical specialties.

IMPROVING COLLABORATIVE CARE FOR INDIVIDUALS WITH ASD, INTELLECTUAL DISABILITY, AND OTHER NEURODEVELOPMENTAL DISORDERS WITHIN A PSYCHIATRIC MEDICAL HOME

In this research Symposium, we will discuss the improvements in access to care within a multidisciplinary neurobehavioral psychiatry care continuum within the Cincinnati Children’s Hospital Medical Center (CCHMC) for youth and adults with a diagnosis of ASD, intellectual disability, or other neurodevelopmental disorders (NDDs). Individuals with NDDs have special healthcare needs and often face numerous barriers to care, leading to healthcare disparities. This care continuum was initially developed in 2014 and includes outpatient psychiatric services, therapies (including speech, occupational, and behavior therapy), diagnostic services, and medical genetics in a co-located space supported by a dedicated team of nurses, medical assistants, behavior support personnel, social workers, and care managers.

RESPONDER: A qualitative study of ethical issues faced by critical care nurses during the COVID-19 pandemic.

AimsTo identify and understand ethical challenges arising during COVID‐19 in intensive care and nurses' perceptions of how they made “good” decisions and provided “good” care when faced with ethical challenges and use of moral resilience.BackgroundLittle is known about the ethical challenges that nurses faced during the COVID‐19 pandemic and ways they responded.DesignQualitative, descriptive free‐text surveys and semi‐structured interviews, underpinned by appreciative inquiry.MethodsNurses working in intensive care in one academic quaternary care centre and three community hospitals in Midwest United States were invited to participate. In total, 49 participants completed free‐text surveys, and seven participants completed interviews. Data were analysed using content analysis.ResultsFive themes captured ethical challenges: implementation of the visitation policy; patients dying alone; surrogate decision‐making; diminished safety and quality of care; and imbalance and injustice between professionals. Four themes captured nurses' responses: personal strength and values, problem‐solving, teamwork and peer support and resources.ConclusionsEthical challenges were not novel but were amplified due to repeated occurrence and duration. Some nurses' demonstrated capacities for moral resilience, but none described drawing on all four capacities.Implications for Nursing ManagementNurse managers would benefit from greater ethics training to support their nursing teams.

Integrated care for HIV/AIDS infected patients. The Romanian experience

The human immunodeficiency virus (HIV) targets the body’s immune system and, if left untreated, may result in acquired immunodeficiency syndrome. (AIDS). HIV’s pathogenesis entails the gradual destruction of CD4+ T cells, which lowers the immune system and leaves the body more susceptible to co-infections and other diseases. HIV has been highlighted as a global public health concern, and since the first instances were recorded in the early 1980s, it has caused extensive morbidity and mortality. The HIV epidemic is still impacting millions of individuals throughout the entire globe, even though available antiretroviral therapy (ART) has transformed HIV infection from an almost universally fatal disease into a controllable chronic medical condition. The magnitude of the HIV epidemic varies between areas and countries. In 2021, the Joint United Nations Program on HIV/AIDS (UNAIDS) projected that 38.4 million individuals worldwide were living with HIV. The HIV integrated care approach highlights the significance of early diagnosis, care coordination, and medication adherence. This strategy incorporates a multidisciplinary team of medical specialists, including physicians, pharmacists, social workers, nurses, and mental health professionals. In addition to medication management, mental health counseling, drug addiction treatment, and peer support, HIV-integrated care includes additional therapies such as behavioral health counseling. HIV integrative care is a holistic approach to HIV infection management that addresses patients’ medical, interpersonal, and emotional requirements. It has been demonstrated that this form of treatment improves health outcomes, reduces stigma, and increases community involvement in combating HIV infections.

COMPLEX CLINICAL HOSPITAL MODEL OF DISCHARGE MANAGEMENT: CONCEPTION AND IMPLEMENTATION

Objective: to present the conception and implementation of the Discharge Management Model of the Clinics Hospital Complex of the Federal University of Paraná. Method: experience report occurred between 2017 and 2020, about the design and implementation of the Discharge Management model with support of the logic model. Results: continuity of care and case management are operationalized by a dedicated team of liaison nurses who manage and counter-reference care to primary care and other points in the health care network. Conclusion: discharge management has been consolidated as a managerial strategy that integrates the health care network, avoids discontinuities in care, promotes patient and family safety, and optimizes beds, and inserts complex patients into the primary care agenda. It contributes to the continuity of care and represents evidence of a new field of work for nurses.

OA27 Growth of the UK and Ireland paediatric rheumatology nurses’ group

OA27 Growth of the UK and Ireland paediatric rheumatology nurses’ group

International Portuguese Nurse Leaders' Insights for Multicultural Nursing.

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. Aim: This study aimed to identify nurse managers’ interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders’ experience in international settings. Methods: A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. Results: Nurse managers’ interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients’ worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories—transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. Conclusions: These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire.

Distractions in the operating room: a survey of the healthcare team.

BackgroundDistractions during surgical procedures are associated with team inefficiency and medical error. Little is published about the healthcare provider’s perception of distraction and its adverse impact in the operating room. We aim to explore the perception of the operating room team on multiple distractions during surgical procedures.MethodsA 26-question survey was administered to surgeons, anesthesia team members, nurses, and scrub technicians at our institution. Respondents were asked to identify and rank multiple distractions and indicate how each distraction might affect the flow of surgery.ResultsThere was 160 responders for a response rate of 19.18% (160/834), of which 71 (44.1%) male and 82 (50.9%) female, 48 (29.8%) surgeons, 59 (36.6%) anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and 53 (32.9%) OR nurses and scrub technicians. Responders were classified into a junior group (< 10 years of experience) and a senior group (≥ 10 years). Auditory distraction followed by equipment were the most distracting factors in the operating room. All potential auditory distractions in this survey were associated with higher percentage of certain level of negative impact on the flow of surgery except for music. The top 5 distractors belonged to equipment and environment categories. Phone calls/ pagers/ beepers and case relevant communications were consistently among the top 5 most common distractors. Case relevant communications, music, teaching, and consultation were the top 4 most perceived positive impact on the flow of surgery. Distractors with higher levels of “bothersome” rating appeared to associate with a higher level of perceived negative impact on the flow of surgery. Vision was the least distracting factor and appeared to cause minimal positive impact on the flow of surgery.ConclusionsTo our knowledge, this is the first survey studying perception of surgery, anesthesia, and OR staff on various distractions in the operating room. Fewer unnecessary distractions might improve the flow of surgery, improve OR teamwork, and potentially improve patient outcomes. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00464-022-09553-8.

Improving Delirium Assessment in Palliative Homecare - A Quality Improvement Project at CanSupport.

Delirium increases distress in patients and caregivers and often leads to hospitalisation and increased health-care costs. It is early diagnosis and management improves the quality of life (QoL) of advanced cancer patients as well as their families. This quality improvement (QI) project aimed at increasing delirium assessment in poor performance advanced cancer patients receiving palliative homecare. The A3 methodology for QI was used. Our SMART goal was to increase the assessment of delirium in poor performance advanced cancer patients from 25% to 50%. The Fishbone and Pareto analysis helped to determine the reasons for low assessment rates. A validated screening tool for delirium assessment was selected and the homecare team doctors and nurses were trained to use it. A flier was designed to help educate families about delirium. Regular use of the tool helped to increase delirium assessment from an initial 25-50% at the time of project completion. The homecare teams learnt the importance of early delirium diagnosis and the need for regular delirium screening. Family caregivers were empowered through education and use of fliers. The QI project helped to improve delirium assessment and leading to improved QoL of patients and their caregivers. Regular training and awareness and continued use of a validated screening tool should help to sustain the results.

Quality Improvement: Implementing Nurse Standard Work in Emergency Department Fast-Track Area to Reduce Patient Length of Stay

IntroductionThe average length of stay of a fast-track area of a large urban hospital was excessively long, which affected the patient experience and the rate at which patients left without being seen. One approach to reducing average length of stay is to create nurse standard work. Nurse standard work was a defined set of process and procedures that reduce variability within a nurse’s workflow. MethodsNurse standard work was created by a team of nurses assisted by management engineering using lean methodology and A3 problem solving. Data were gathered about average length of stay and left without being seen for patients in the emergency department fast-track area of an urban emergency department from October 2018 to June 2020. This period includes 5 months before the intervention start, 4 months during nurse standard work implementation, 9 months using nurse standard work before the unit was repurposed during COVID-19, and 3 months during COVID-19. ResultsNurse standard work helped reduce average length of stay in the emergency department fast-track area from 205 minutes before project initiation to 150.4 minutes in the 7 months after implementing nurse standard work. The time spent walking for supplies was reduced from 422 and 272 seconds before nurse standard work to 25 and 30 seconds for the nurse technician and nurse, respectively, after nurse standard work. Left without being seen was decreased from 4.7% in October of 2018 to 0.7% by March of 2020. DiscussionNurse standard work reduced the amount of time that nurses spent performing support tasks and reduced delays in providing patient care, which then allowed more time for nurses to interact directly with patients. Nurse standard work provides a clear task sequence that eliminates delays in treating patients, but it also allows for fast identification of delays that do occur and simplifies problem solving to eliminate reoccurrence of delays. Therefore, nurse standard work is an essential component of efforts to reduce patient average length of stay in health care processes and reduce left without being seen to the national standard of less than 2%.

Rural trauma telementoring: a pilot project.

Background:Given Canada’s geographically dispersed population, initial trauma care may occur at rural sites that may not manage patients with trauma frequently; thus, telementoring can play a life-saving role. In this article, we describe a rural trauma telementoring pilot program in British Columbia and report the results of an evaluation of its strengths and weaknesses.Methods:Trauma surgeons from a quaternary trauma centre in Vancouver helped facilitate 3 in situ trauma simulation sessions at a rural BC hospital between fall 2019 and summer 2020. The sessions involved 4 physician participants (a trauma surgeon telementor, a family physician with additional expertise in emergency medicine acting as trauma team leader, a family physician with additional expertise in anesthesia and a family physician with Enhanced Surgical Skills), an emergency department nurse, 2 operating room/trauma team nurses, and laboratory and radiology technicians. The sessions involved simulated damage-control procedures and lasted about 2 hours. The participants completed surveys assessing comfort and confidence regarding aspects of trauma care and use of the telehealth unit before and after each session, and the facilitators assessed team dynamics using the Modified Non-Technical Skills for Trauma (T-NOTECHS) tool. Focus groups were held to gather qualitative data, and costs were tracked.Results:The average presimulation confidence survey score was 19.6/30, and the average postsimulation score was 24.0/30. The mean score improved significantly after both the first and second sessions (p = 0.01 and p = 0.004, respectively). Across the 3 sessions, the average T-NOTECHS score improved significantly, from 18.5/25 to 21.5/25 (p = 0.02). Qualitative analysis identified 3 dominant themes: telementoring increased provider confidence, telementoring increased order to the resuscitation procedure and the technical aspects of telementorship. The telementoring program was well received by all participants.Conclusion:A significant improvement was seen across simulations in physician confidence and trauma team dynamics with telementorship support. Telementoring in trauma may provide a way to lessen the difference between rural and urban patient outcomes within Canada’s geographically dispersed population, although further work investigating the impact of its use in real-life patients, as well as barriers to its implementation, is required.

CN6 E-health applied to oncology treatment, education and knowledge for cancer care: A systematic review

E-health, by WHO definition, incorporates a range of standards, tools and activities that use electronic means to deliver information, resources and services about health and social care. At the heart of e-health is a vision of improving the quality of health information, strengthening national health systems and ensuring accessible, high-quality health care for all. The use of e-health interventions is effective in improving patient experiences and outcomes. To increase evidence about supportive e-health interventions that include nursing interventions for education to oncology patients under treatment. Subsequently to improve the quality of oncology care by analysing the data in a potential model for e-health application and how efficient health systems are. The review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines (PRISMA). terms related to cancer, e-health, telemedicine and nursing interventions were searched in the following databases: CINAHL® Plus, Nursing & Allied Health Collection, Cochrane Plus Collection, MEDLINE®, EBSCOhost, Scopus & Joanna Briggs from the last five years. Languages as: English, Spanish and Portuguese, published in last 5 years (January 2017 till February 2022). Seventeen (n = 17) studies were identified. Different designs; quantitative and qualitative methods were included. Reviews and Systematic reviews, prospective cohorts, quasi-experimental and pilot studies were included. The results focus on a technology-based intervention that aims to improve cancer care, health and wellbeing; All the interventions were applied to cancer patients, apply for cancer caregivers (n=1) and young adults with cancer (n=1). E-Health has an enormous potential to improve healthcare cost, effectiveness, and quality of care. Feasibility of internet-based was demonstrated, E-Health use in clinical oncology has had a significant impact on the delivery of cancer care. Nurses in multidisciplinary teams are considerate well placed to support adherence to treatment among cancer patients, E-health helps to manage better care because it can simplify interprofessional team care.

Simple signature/countersignature shared-accountability quality improvement initiative to improve reliability of blood sample collection: an essential clinical task

BackgroundTimely lab results are important to clinical decision-making and hospital flow. However, at our institution, unreliable blood sample collection for patients with central venous access jeopardised this outcome and created...

Dissemination Strategies of a Nonfatal Strangulation Program: Success of an Interagency Initiative

BackgroundNonfatal strangulation has been identified as a common occurrence in intimate partner violence and can be associated with significant injuries and, at times, increased mortality. ObjectiveThis article describes a county interagency nonfatal strangulation initiative that efficiently disseminated an educational program for police, emergency medical services, emergency department staff, forensic nursing teams, and prosecuting attorneys, along with a forensic nurse response program. Prior to initiation of this program, no educational programs existed and no forensic examinations were being offered to victims of nonfatal strangulation. MethodsEarly cooperation between agencies was crucial, particularly between the two major health care systems in the county. A standardized forensic evaluation tool was developed, along with nonfatal strangulation courses. Education of forensic nurses together with prosecutors was unique and training of police, emergency medical services, and emergency department staff was coordinated. Forensic nurses traveled to meet victims for standardized examinations at 11 emergency departments. Creation of a secure Research Electronic Data Capture database captured forensic examination information and a strangulation task force provided means to assess the goals. ResultsThis initiative educated > 80% of the county’s first responders and 79% of emergency department staff within 3 months. During the first year of the program, 259 forensic nurse examinations for nonfatal strangulation were recorded. Police reported a total of 367 arrests for felony assault by strangulation. ConclusionsProfessionals providing legal and medical care to victims of nonfatal strangulation can be educated and forensic nurse examinations can be implemented successfully in an expeditious period of time with a county collaborative program approach.

Impact of an Infant-Driven Feeding Initiative on Feeding Outcomes in the Preterm Neonate.

Poor feeding techniques result in adverse outcomes for preterm infants. Infant-driven feeding (IDF) is a structured feeding method that standardizes neonatal cue-based feedings, and matches the neurodevelopmental stage of the preterm infant. The purpose of this quality improvement project is to assess whether initiation of an IDF initiative impacts time from first nipple feed (NF) to full NF and to discharge in infants born before 35 weeks' gestational age. Secondary aims include assessment of the impact of IDF on neonatal growth and feasibility of following an IDF protocol in a level III neonatal intensive care unit (NICU). This quality improvement project assesses differences in time to first NF, length of hospital stay, and neonatal growth before and after usage of an IDF protocol. Eighty infants were included, 40 prior to and 40 after IDF intervention. Nurses were trained on IDF philosophy and methods prior to initiation. IDF was associated with discharge at a younger corrected gestational age (CGA), attainment of ad lib feeds at a younger CGA, and shorter amount of days between first NF and discharge. Infants utilizing IDF had slower weight gain, demonstrated by a larger drop in z score in the IDF group. The medical team and bedside nurses were able to follow the IDF protocol with few exceptions. IDF allows for optimization of a preterm infant's NICU stay and prepares infants for a safe discharge sooner. This could lead to increased parental satisfaction and decreased hospital cost. Further studies are indicated to ensure these benefits remain and focus on impact direct breastfeeding plays in the IDF model.

Drivers of shared decision making in inpatient psychiatry: An exploratory survey of patients' and multi-disciplinary team members' perspectives

ObjectiveTo assess the prevalence and predictors of Shared Decision Making (SDM) in an adult, inpatient psychiatric setting. MethodMulti-disciplinary clinician focus groups and patient pre-testing informed the development of a survey on 4 SDM and 11 factors hypothesized to interfere with SDM. The survey was administered to 89 adult inpatients (80% response rate) and their treatment team psychiatrists, nurses, and social workers (n = 338 ratings, 95% response rate). Group differences and predictors were estimated using t and F-tests. ResultsPatients' mean SDM score (n = 64, standardized Cronbach alpha = 0.858) was 3.35 ± 1.13 (5 = highest agreement), and correlated with overall satisfaction with care (n = 61, r = 0.399, p = 0.001). Patients' disagreement with clinician's diagnosis (44% of patients) correlated with lower SDM ratings by patients (t = 2.55, df = 62, p = 0.013) and by clinicians (t = 2.99, df = 69, p = 0.004). Psychotic diagnoses were not a significant determining factor for SDM. Overall, clinicians rated SDM more favorably than patients (t = −5.43, df = 63, p < 0.001), with nurses and social workers rating SDM higher than physicians (p < 0.001). ConclusionsDiagnostic agreement / disagreement is a key predictor of SDM for patients and clinicians, while presence of psychosis is not. SDM was rated higher by clinicians than patients. SDM ratings vary significantly between clinical disciplines.

Exploration of a rapid response team model of care: A descriptive dual methods study

BackgroundAvoidable in-patient clinical deterioration results in serious adverse events and up to 80% are preventable. Rapid response systems allow early recognition and response to clinical deterioration. ObjectiveTo explore the characteristics of a collaborative rapid response team model. DesignDual methodology was used for this descriptive study. SettingThe study was conducted in a 500-bed tertiary referral hospital (Sydney, Australia). ParticipantsInpatients (>17 years) who received a rapid response team activation were included in an electronic medical audit. Participants were rapid response team members and nurses and medical doctors in two in-patient wards. MethodsA 12-month (January-December 2018) retrospective electronic health record audit and semi-structured interviews with nurses and medical doctors (July-August 2019) were conducted. Descriptive statistics summarised audit data. Interviews were transcribed and analysed thematically. ResultsThe rapid response team consulted for 2195 patients. Mean patient age was 67.9 years, and 46% of the sample was female. Activations (n = 4092) occurred most often in general medicine (n = 1124, 70.8%) units. Overall, 117 patients had >5 activations. The themes synthesised from interviews were i) managing patient deterioration before arrival of the rapid response team; ii) collaboratively managing patient deterioration at the bedside; iii) rapid response team guidance at the bedside; and iv) ‘staff concern’ rapid response activation. ConclusionsSome patients received many activations, however few required treatment in critical care. The rapid response model was collaborative and supportive. The themes revealed a focus on patient safety, optimising early detection, and management of patient deterioration.