When Andrea Burnette gave birth to twin boys six weeks prematurely, she knew they might require extra medical attention. And indeed, both MaCari and CaMari stayed in the intensive care unit at North Carolina Children’s Hospital in Chapel Hill, North Carolina, for a few months, while their lungs developed and they gained strength enough to go home.
MaCari came home first. But within days Burnette brought him back to the hospital, concerned about his rapid breathing. While the nurse tried to reach the doctor, Andrea became even more alarmed as her baby’s breathing worsened. “So I called the Rapid Response Team and they rushed in and got him in to the PICU right away,” she recalls. “They stabilized him, and now he’s fine.”
Most hospitals with Rapid Response Teams — an intervention in IHI’s 5 Million Lives Campaign — do not invite patients or family members to call the Team directly, but that is beginning to change, especially in pediatric hospitals. North Carolina Children’s decided in the Spring of 2007 to give family members the same direct access to the Team as the rest of the medical staff. Patients and families view the Rapid Response Team as an extension of the clinical team already taking care of their child, a kind of safety net.
“Some staff were worried families would call for non-urgent things,” says pediatric intensivist Tina Schade Willis, MD. But experience at other hospitals doesn’t bear that out. “Parents would never call 911 from home for something trivial,” says Jordan Erickson, the hospital’s Quality Analyst who helped to implement the Rapid Response strategy. “Why would they do it here? This communicates to families that they are part of the medical team.”
Willis agrees. “Parents know their children best,” she says, which is why about 20 percent of the 5 to 8 calls from staff members to the Team each month include family concern as one of the reasons for the call. Of those calls, Willis says that about 70 percent of the pediatric patients are transferred to the ICU because they do indeed require a higher level of care.
06/01/2008
