TY - JOUR
T1 - Characteristics of Rapid Response Calls in the United States
T2 - An Analysis of the First 402,023 Adult Cases From the Get With the Guidelines Resuscitation-Medical Emergency Team Registry
AU - American Heart Association’s Get With the Guidelines – Resuscitation Investigators
AU - Lyons, Patrick G.
AU - Edelson, Dana P.
AU - Carey, Kyle A.
AU - Twu, Nicole M.
AU - Chan, Paul S.
AU - Peberdy, Mary Ann
AU - Praestgaard, Amy
AU - Churpek, Matthew M.
N1 - Funding Information:
Dr. Lyons’ institution received funding from a National Institutes of Health (NIH) T32 grant (5T32 HL007317). Drs. Lyons, Chan, and Churpek re- ceived support for article research from the NIH. Dr. Edelson’s institution received funding from EarlySense, Tel Aviv, Israel and Philips Healthcare, Andover, MA. Drs. Edelson and Churpek disclosed received funding from a Patent Pending (ARCD.P0535US.P2) for risk stratification algorithms for hospitalized patients. Dr. Chan is supported by a research grant award from the National Institutes of Health (1R01 HL123980). Ms. Praest- gaard’s institution received funding from American Heart Association. Dr. Rapid response teams (RRTs) have been widely imple-supported by a career development award from the National Heart, Lung, Churpek received support from the National Institutes of Health, and he is mented across U.S. hospitals since the Joint Com-and Blood Institute (K08 HL121080). The remaining authors have dis- mission spurred their proliferation through the 2008 closed that they do not have any potential conflicts of interest. Patient Safety Goals (1). First described in the medical litera- Address requests for reprints to: Matthew M. Churpek, University of Chi-ture in the early 1990s (2), these teams quickly respond to hos-5841 South Maryland Avenue, MC 6076, Chicago, IL 60637. E-mail: cago Medical Center, Section of Pulmonary and Critical Care Medicine, pitalized patients with acute clinical deterioration, generally matthew.churpek@uchospitals.edu outside of critical care areas, with the goal of preventing in-Copyright © 2019 by the Society of Critical Care Medicine and Wolters hospital cardiac arrest and mortality. Although the 23-center Kluwer Health, Inc. All Rights Reserved. Medical Early Response Intervention and Therapy (MERIT) DOI: 10.1097/CCM.0000000000003912 cluster randomized trial failed to demonstrate improved
Publisher Copyright:
Copyright © 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
PY - 2018/10
Y1 - 2018/10
N2 - Objectives: To characterize the rapid response team activations, and the patients receiving them, in the American Heart Association-sponsored Get With The Guidelines Resuscitation-Medical Emergency Team cohort between 2005 and 2015. Design: Retrospective multicenter cohort study. Setting: Three hundred sixty U.S. hospitals. Patients: Consecutive adult patients experiencing rapid response team activation. Interventions: Rapid response team activation. Measurements and Main Results: The cohort included 402,023 rapid response team activations from 347,401 unique healthcare encounters. Respiratory triggers (38.0%) and cardiac triggers (37.4%) were most common. The most frequent interventions—pulse oximetry (66.5%), other monitoring (59.6%), and supplemental oxygen (62.0%)—were noninvasive. Fluids were the most common medication ordered (19.3%), but new antibiotic orders were rare (1.2%). More than 10% of rapid response teams resulted in code status changes. Hospital mortality was over 14% and increased with subsequent rapid response activations. Conclusions: Although patients requiring rapid response team activation have high inpatient mortality, most rapid response team activations involve relatively few interventions, which may limit these teams’ ability to improve patient outcomes.
AB - Objectives: To characterize the rapid response team activations, and the patients receiving them, in the American Heart Association-sponsored Get With The Guidelines Resuscitation-Medical Emergency Team cohort between 2005 and 2015. Design: Retrospective multicenter cohort study. Setting: Three hundred sixty U.S. hospitals. Patients: Consecutive adult patients experiencing rapid response team activation. Interventions: Rapid response team activation. Measurements and Main Results: The cohort included 402,023 rapid response team activations from 347,401 unique healthcare encounters. Respiratory triggers (38.0%) and cardiac triggers (37.4%) were most common. The most frequent interventions—pulse oximetry (66.5%), other monitoring (59.6%), and supplemental oxygen (62.0%)—were noninvasive. Fluids were the most common medication ordered (19.3%), but new antibiotic orders were rare (1.2%). More than 10% of rapid response teams resulted in code status changes. Hospital mortality was over 14% and increased with subsequent rapid response activations. Conclusions: Although patients requiring rapid response team activation have high inpatient mortality, most rapid response team activations involve relatively few interventions, which may limit these teams’ ability to improve patient outcomes.
KW - clinical deterioration
KW - early warning systems
KW - hospital mortality
KW - hospital quality and safety
KW - outcomes
KW - rapid response teams
UR - http://www.scopus.com/inward/record.url?scp=85072234207&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000003912
DO - 10.1097/CCM.0000000000003912
M3 - Article
C2 - 31343475
AN - SCOPUS:85072234207
SN - 0090-3493
VL - 47
SP - 1283
EP - 1289
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 10
ER -