Supporting Regional Response Team Learning Networks

In December 2005, as part of its efforts to improve the safety and quality of patient care in hospitals, the Robert Wood Johnson Foundation (RWJF) funded nine hospital associations and health care systems with grants of up to $150,000 apiece for each to work with at least 25 of their member hospitals to establish rapid response teams.

A rapid response team (known by some as a medical emergency team) is a group of clinicians—including seasoned intensive care nurses, respiratory therapists and in some cases physicians—that nurses and other hospital staff can call upon at any time to provide critical care expertise at the bedside of a patient whose condition is deteriorating.

First implemented in Australia and the United Kingdom, rapid response teams appeared to be a promising intervention. Results from Australia suggested that in a hypothetical hospital with 20,000 annual admissions, a rapid response team could save as many as 60 lives each year. In fact, results from a single hospital in Australia reported in the February 16, 2002, issue of the British Medical Journal showed a 50 percent reduction in "unexpected" cardiac arrests.

During the program, 842 hospitals across the nine grantee organizations implemented rapid response teams. The grantees reported reductions in mortality and codes. The Institute for Healthcare Improvement (IHI), the national program office, updated a Rapid Response Team Getting Started Kit and annotated bibliography. The guide and bibliography are available on the IHI website.

The Joint Commission—a healthcare organization accrediting body—added early detection of patient deterioration ("Improve recognition and response to changes in a patient's condition") to its 2008 Patient Safety Goals. By January 1, 2009, all hospitals accredited by the Joint Commission were also required to enable patients and/or family members to request such assistance when the patient's condition appeared to be worsening.

A group of researchers at the University of California at San Francisco School of Nursing, led by Nancy Donaldson, DNSc, RN, FAAN, conducted an evaluation of Supporting Regional Response Team Learning Networks from December 2005 through April 2008. In its final report to RWJF, the research team concluded that "the most significant impact of the rapid response team, as observed in this study, may actually be found among the nurses who experience [it] as life-saving to their patients, affirming in their role and workload ameliorating."