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The Impact of Proactive Rounding on Rapid Response Team calls: An Observational Study.
Hosp Pract (1995). 2018 Nov 08;:
Authors: Kara A, Dean DF, Johnson CS, Hui SL
Abstract
BACKGROUND: Rapid response teams (RRTs) improve mortality by intervening in the hours preceding arrest. Implementation of these teams varies across institutions.
SETTING AND DESIGN: Our healthcare system has two different RRT models at two hospitals: Hospital A does not utilize a proactive rounder while Hospital B does. We studied the patterns of RRT calls at each hospital focusing on the differences between night and day and during nursing shift transitions.
RESULTS: The presence of proactive surveillance appeared to be associated with an increased total number of RRT calls with more than twice as many calls made at the smaller Hospital B than Hospital A. Hospital B had more calls in the daytime compared to the night-time. Both hospitals showed a surge in the night-to-day shift transition (7am-8am) compared to the preceding night-time. Hospital A additionally showed a surge in calls during the day-to-night shift transition (7pm- 8pm) compared to the preceding daytime.
CONCLUSIONS: Differences in the diurnal patterns of RRT activation exist between hospitals even within the same system. As a continuously learning system, each hospital should consider tracking these patterns to identify their unique vulnerabilities. More calls are noted between 7am-8am compared to the overnight hours. This may represent the re-establishment of the 'afferent' arm of the RRT as the hospital returns to daytime staffing and activity. Factors that influence the impact of proactive rounding on RRT performance may deserve further study.
PMID: 30409047 [PubMed - as supplied by publisher]