Responding quickly to a patient's crisis is nothing new. But the idea of heading off medical crisis by watching someone carefully and catching the first hint there's an impending crisis, is.
Now the Institute for Healthcare Improvement has made rapid-response teams like that used by LDS Hospital, one of the pioneers, part of its "100,000 Lives" campaign to improve patient outcomes.
Colleen Eversole, Salt Lake City, knows firsthand how important the program is. She had been hospitalized after a replaced knee developed an infection. Routine heart monitoring showed that her heart rate had gone sky high and they called in the rapid response team.
"They came in and examined me and made the decision to move me to the heart floor," she said. The 57-year-old had had a previous heart attack; she's convinced their quick action averted another one. She spent a week there before going home, but she's got more heart work, including a heart ablation Tuesday, before she can get a replacement artificial knee.
"The rapid-response team worked real well," she says. "Without them making the decisions, I would have been in a world of hurt."
"It's an excellent thing," says intensive care unit nurse manager Dan Davis, a team member. "I think we prevent patients from dying in certain circumstances. Now we're moving to encouraging family who are often the best judge of a patient's baseline to speak up. 'Dan's behavior is not like him. Why don't you call the rapid-response team?"'
If there's a question about a patient's status, the team wants to be called, he says. "Whether it's warranted is irrelevant. Call us if there's a question. I think it will be used more and more in hospitals. Evidence (including research in Australia and the United States) says it says lives. We're excited about it."
The LDS Hospital teams include an ICU nurse, the respiratory therapy and nursing supervisors and a house physician, backed up by critical care doctors and hospitalists and other specialists, as needed.
The team was created to "do everything possible" to help eliminate medical errors and catastrophic patient outcomes, according to Dr. Terry Clemmer, critical care physician.
They respond to all kinds of distress, including respiratory, neurological and cardiac. Clemmer says the team's efforts have reduced medical errors and mortality rates at a time when many hospitals are battling those numbers. It has also improved communication staffwide.
Signals that may summon the team include an acute change in vital signs, or in the level of consciousness that can't be explained, or even "just an uneasy feeling," Davis says. "Our goal is to avoid a turn for the worse by assessing and intervening."
Too often, an unexpected change prompts a "let's watch this and see what it does" approach. Now, caregivers are being asked to be more proactive.Last month, the group responded to nine calls for help and the numbers seem to be climbing. They're trying to boost the comfort level with making the call by doing follow up and saying thanks. "We don't judge. Even if it turns out to be nothing, we thank them."
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