A novel configuration of a traditional rapid response team decreases non-intensive care unit arrests and overall hospital mortality

BACKGROUNDIn-hospital cardiopulmonary arrest (CPA) accounts for substantial morbidity and mortality. Rapid response teams (RRTs) are designed to prevent non-intensive care unit (ICU) CPA through early detection and intervention. However, existing evidence has not consistently demonstrated a clear benefit. OBJECTIVETo explore the effectiveness of a novel RRT program design to decrease non-ICU CPA and overall hospital mortality. METHODSThis study was conducted from the start of fiscal year 2005 to 2011. In November 2007, our hospitals implemented RRTs as part of a novel resuscitation program. Charge nurses from each inpatient unit underwent training as unit-specific RRT members. Additionally, all inpatient staff received annual training in RRT concepts including surveillance and recognition of deterioration. We compared the incidence of ICU and non-ICU CPA from first complete preimplementation year 2006 to postimplementation years 2007 to 2011. Overall hospital mortality was also reported. RESULTSThe incidence of non-ICU CPA decreased, whereas the incidence of ICU CPA remained unchanged. Overall hospital mortality also decreased (2.12% to 1.74%, P<0.001). The year-over-year change in RRT activations was inversely related to the change in Code Blue activations for each inpatient unit (r=-0.68, P<0.001). CONCLUSIONOur novel RRT program was associated with a decreased incidence of non-ICU CPA and improved hospital mortality. Journal of Hospital Medicine 2015;10:352-357. (c) 2015 Society of Hospital Medicine