The Rapid Response Team — known by some as the Medical Emergency Team — is a team of clinicians who bring critical care expertise to the bedside.  Simply put, the purpose of the Rapid Response Team is to bring critical care expertise to the patient bedside (or wherever it’s needed).

There is a large amount of variability in both quality of care and the safety of patients in health care today.  This variability is evident in hospital mortality rates. [1]  A review of the literature and our experience reveals that there are three main systemic issues contribute to the problem: 

• Failures in planning (includes assessments, treatments, goals)
• Failure to communicate (patient to staff, staff to staff, staff to physician, etc.)
• Failure to recognize deteriorating patient condition

These fundamental problems can often lead to a failure to rescue. Establishing rapid response teams stands to impact this state of affairs by identifying unstable patients and those patients likely to suffer cardiac or respiratory arrest.  If identified in a timely fashion, their unnecessary deaths can often be prevented.

Rapid Response Team Results:

Measure:             Before:                After:        Rel Risk Reduction:

No. cardiac
arrests                     63                      22                  65% (p=.001)

Deaths from
cardiac arrest           37                      16                   56% (p=.005)

No. days in
ICU post arrest        163                     33                   80% (p=.001)

No. days in
hospital post arrest  1363                   159                  88% (p=.001)

Inpatient Deaths       302                    222                  25% (p=.004)

*Table adapted from Bellomo R, Goldsmith D, Uchino S, et al. A prospective before-and-after trial of a medical emergency team. Medical Journal of Australia. 2003;179(6):283-287.

The first step in convincing yourself and your colleagues of the need for a rapid response team is to review the charts of several patients that suffered cardiac or respiratory arrest in your institution.  Most often when you review the chart you will find alterations in subjective complaints, vital signs, nursing documentation that precede the event from hours to days in advance. 

Your results will most likely confirm what many practitioners know: people die unnecessarily every single day in our hospitals.  The results in the chart above confirm this suggestion.  In establishing a rapid response team, the goal is to respond to a “spark” (patient complaints, signs, symptoms) before it becomes a “forest fire” (cardiac or respiratory arrest).

References: 

1. Jarman B, Nolan T, Resar R. Move Your Dot™: Measuring, Evaluating, and Reducing Hospital Mortality Rates (Part 1). IHI Innovation Series white paper.Boston, Massachusetts: Institute for Healthcare Improvement; 2003.