Rapid Response Teams to Respond to Critical Care Situations

Intervention Title:
Rapid Response Teams to Respond to Critical Care Situations – North Shore-Long Island Jewish Hospital (NS-LIJ), Great Neck, N.Y.

Goal:
Improve critical care delivered to patients through a rapid response team of clinicians.

Innovation:
Teams were trained to better respond to critical patient situations.

Result:
Codes have decreased, and assessment skills have increased to recognize situations needing response before they evolve into a code.

Institution:
North Shore-Long Island Jewish Hospital
400 Lakeville Road
Suite 170 - Institute for Nursing
New Hyde Park, NY 11042
P: (718) 470-7000

From the experts:
“Rapid response teams have helped us learn how to address issues before they require a code. We hope our staff's skills to provide early assessment of a patient's situation will be so fine-tuned that rapid response teams can actually be eliminated.”

Kerri Scanlon, M.S.N., A.N.P.
Chief Nursing Officer
North Shore-Long Island Jewish Hospital

Profile:
North Shore-Long Island Jewish Hospital is a network comprised of 15 hospitals, headquartered in Great Neck, N.Y.

Clinical areas affected:

  • Medical and surgical units

Staff involved:

  • Nurses
  • Physicians
  • Quality department
  • Respiratory therapists
  • Intensive care unit
  • Residents
  • Critical care nurses

Timeline:
Staff spent two to three months determining the types of response teams needed, identifying staff members necessary for each team, and developing an appropriate algorithm for medical and surgical patients.

Contact:
Kerri Scanlon
Chief Nursing Officer
P: (718) 470-7973
kscanlon@lij.edu

Innovation implementation:
Establishing rapid response teams provides hospitals with a mechanism to quickly identify suddenly unstable patients and provide immediate critical care. For patients likely to suffer cardiac or respiratory arrest, these quick medical responses can be life saving. North Shore-Long Island Jewish Hospital instituted rapid response teams to “rescue” patients before a crisis occurs.

NS-LIJ began developing teams by identifying which providers should be included. Teams include different domains, such as respiratory therapists, intensive care, residents and critical care nurses. Team members take turns carrying the rapid response team pager. When there is a call, the member of the team with the pager contacts the team to respond, along with the attending nurse.

As part of the introduction of rapid response teams, the quality department was involved in the development and dissemination of an education program to help providers improve assessment skills and identify patient problems earlier. Rapid response teams are not seen as a permanent resource, but instead as a learning tool to help improve assessment skills and develop better standards of care that will supersede the need for these teams.

Advice and lessons learned:

  1. Educate all staff at once. Educate nurses and medical staff together so everyone is on the same page at the same time.
  2. Learn from the responses of the rapid response team. Examining the reasons for each instance requiring a rapid response team helped providers improve assessment skills by identifying issues that should be addressed sooner.
  3. Underscore that patients are the priority. Individuals sometimes feel that they have been circumvented when a rapid response team is called instead of them, so it's important to emphasize that helping the patient is the priority.

Cost/benefit estimate:

N/A

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