Medical Emergency Teams/Rapid Response Teams: Purpose and Benefits
Medical emergency response teams, also known as rapid response teams, can play a vital role in the reduction of respiratory and/or cardiac arrests and improve patient outcomes. These teams usually consist of healthcare professionals who bring critical care knowledge to the patient’s bedside.
The idea for rapid response teams was born after the Institute for Healthcare Improvement developed a plan to improve patient safety. Six initiatives were developed and implemented by the institute, including rapid response teams.
What Goes Wrong?
It is important to understand the factors that contribute to a patient’s declining condition not being identified until a life-threatening situation develops. In some cases, a patient may develop cardiac or respiratory arrest without prior warning, but in most instances there are warning signs and a gradual deterioration of the patient’s condition. These early warning signs may not be recognized for a few common reasons.
One reason a patient’s decline may not be identified prior to a life-threatening event is a failure in communication. Failure in communication may occur either between the patient and the staff or between staff members. Essentially, things slip through the crack. For example, during patient report at the change of shift, relevant information may not be given or heard. In other cases, a patient may not report symptoms to the nurse. Not having all the available information can prevent a clear picture of what is going on with the patient.
Another reason why some conditions are not caught early is failure to recognize a change in status or a patient’s deteriorating condition. In other cases, symptoms are recognized too late to prevent respiratory failure or cardiac arrest.
Purpose and Benefits of a Rapid Response Team
By identifying unstable patients who may be headed for respiratory failure, cardiac arrest, stroke or another serious situation, staff can intervene and prevent such an event. For example, patients often develop signs such as increased respiratory rate, anxiety and changes in mental status before a cardiac arrest. Identifying a patient in the early stages of decline can prevent a worsening situation.
Members of a rapid response team are trained and have the expertise to recognize early signs of many conditions, such as stroke, sepsis, myocardial infarction and impending respiratory failure. By identifying these conditions early, appropriate interventions and treatments can be implemented.
According to the Institute for Healthcare Improvement, rapid response teams can decrease the number of cardiac arrests, deaths from cardiac arrests, number of days in the intensive care unit after cardiac arrest and number of impatient deaths. Knowing the benefits of having a rapid response team, it is not surprising that increasing numbers of healthcare facilities are using these teams.
Rapid Response Team Suggestions
In order to develop a successful rapid response team, consider some of the suggestions below.
Include team members with varied expertise: A critical component of a rapid response team is the varied expertise the team members bring. When implementing such a team, careful consideration of which healthcare professionals will be part of the rapid response team is important. This may seem easy and obvious, but making sure your team has diverse knowledge will make for a well-rounded group. The number of members of a rapid response team may vary. Some hospitals choose to have one or two team members while others have five or six.
In many instances, hospitals choose to include a critical care nurse, respiratory therapist and nursing supervisor. Some hospitals also include a physician or a physician’s assistant and a pharmacist as part of the rapid response team. Whichever team members are included, they must be able to respond to a page immediately.
Develop protocols: It is helpful to develop protocols that team members can utilize when responding to any given situation. For example, instead of having to call the physician for an order to draw an arterial blood gas, an ABG can be part of the standard RRT protocol. Having protocols saves time in obtaining physician orders and may allow for faster assessment of the situation and subsequent treatment.
Establish criteria for activating the rapid response team: Make sure healthcare staff have a clear understanding of the criteria used to call an RRT. Nurses and other healthcare professionals in all patient care areas should be aware of the indications to activate a rapid response. Examples of criteria for a rapid response may include an acute change in heart rate above 130 or below 40, decrease in the level of consciousness or a decrease in oxygen saturation below 90 percent with supplemental oxygenation.
Institute for Healthcare Improvement. Establish a Rapid Response Team. http://www.ihi.org/resources/Pages/Changes/EstablishaRapidResponseTeam.aspx Accessed July 2014.
National Institute of Health. Rapid Response Teams in Hospitals Increase Patient Safety. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873718/ Accessed July 2014.