The Program Being Evaluated
From 2004 through 2006, the Supporting Regional Response Team Learning Networks program provided support to nine health care systems to establish learning networks to help hospitals implement and test rapid response team (RRT) interventions, which is a promising approach to improve patient outcomes and improve the work environment for nurses. RRTs have been shown to empower medical-surgical nurses and others who can activate a support system when they are unsure about a patient's possible deteriorating condition. Hospital rapid response teams are able to assess and manage deteriorating patients before their condition becomes an emergency.
About the Evaluation
This multisite evaluation was led by Nancy Donaldson, D.N.Sc., F.A.A.N., R.N., of the University of California, San Francisco, School of Nursing. Launched after grantee projects were in progress, the evaluation addressed four main questions:
- Which factors are associated with successful RRT implementation?
- What strategies exist for organizing a more effective RRT system?
- What are the standard process and outcome measures of a RRT?
- How do nurses feel about the RRT?
Summary of Methods
Qualitative data gathered from the nine sites informed the evaluation team of common characteristics across hospitals and RRT systems. The qualitative evaluation included on-site interviews with 56 registered nurses from acute care units and with RRT experience, 12 RRT leaders and 18 chief nursing officers.
Knowledge and Impact
The evaluation findings report substantial variation of RRT usage across the hospitals within the nine grants. The nurse interviews reported RRT activation for apparent changes in the vital signs or mental status in patients; the nurse “had a gut feeling” something was wrong; and physicians were unavailable for urgent help. Nurses reported that RRT was like a “hospital 911” that was responsive and supportive to them. The evaluation found that robust adopter hospitals had more visible senior staff, actively sought nurse input and strong communications and training, including emphasizing that all RRT calls were both important and valid. RRT leaders noted across all sites that implementation difficulties were linked to resources, communications, training and competing priorities. This evaluation demonstrated the RRT is both important to patients and to the affirmation of a nurse’s role.