Imagine Mr. Patient, an Auburn Memorial Hospital patient on 4 Central who was admitted for pneumonia. He has been alert and oriented, but a nurse notices that he has become lethargic, is not talking clearly and is having increased respiratory distress. His skin is pale. The nurse's assessment is that he may be going into congestive heart failure. At this point, a Rapid Response Team can very possibly save Mr. Patient's life.

Auburn Memorial Hospital implemented a “Rapid Response Team” system (RRT) in March. An RRT is a multidisciplinary team of clinicians who bring critical care expertise to the patient's bedside (or wherever it is needed). The goal is to prevent deaths by recognizing and treating patients whose condition is deteriorating prior to their suffering a cardiac or respiratory arrest.

Historically, hospitals only brought advanced care to a patient's bedside after a cardiac or respiratory arrest. This practice was costly and often unsuccessful. Research has shown that 84 percent of patients have signs and symptoms of deterioration before an arrest. Health care practitioners began to recognize that patients would benefit more from rescue than resuscitation, and RRT was born.

The first team was pioneered in 1990 at a teaching hospital of the University of New South Wales near Sydney, Australia. Since then, the RRT concept has taken off, with the support of the Institute for Healthcare Improvement (IHI). Today, there are more than 950 RRTs in U.S. hospitals.

The RRT can be called for any inpatient situation where a higher level of support is desired for a patient who is experiencing an unanticipated change in condition. The underlying premise is to “rescue” the patient before the patient requires the intervention of resuscitation by an Emergency Cart Response.

From the program's inception in March through mid-August, there were 23 RRTs and 14 Emergency Cart calls at AMH. Twelve patients were transferred to critical care and eight were stabilized and were able to remain on the medical/surgical unit. The RRT is comprised of a critical care nurse, a respiratory therapist and the nursing supervisor, and if available, a hospitalist, attending or nurse practitioner. The patient is evaluated and any necessary interventions are performed. Should the patient's condition deteriorate, the level of response can be increased to a full Emergency Cart Response.

Roz McCormick, vice president for Patient Care Services, stated: “We are very pleased with the success of this program to date. We are saving lives and improving care, and we will continue to evaluate the outcomes of this very promising initiative.”

Beverly Miller is the director of community relations and the Hospital Foundation at Auburn Memorial Hospital.