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Fluids & Electrolytes
In a large study spanning 31/2 years in one midwestern hospital, the rapid response team didn't achieve its mission of reducing hospital-wide cardiopulmonary arrest (code) rates or mortality outside the ICU. A rapid response team is composed of clinicians trained to respond to impending emergencies at the bedside, before a code situation develops.
Researchers compared 24,193 patients who were hospitalized before the rapid response team was initiated with 24,978 patients who were hospitalized after the team had begun working. Researchers tracked codes and deaths both in and out of the ICU.
During a 20-month period, the rapid response team was activated 376 times. The results: Hospital-wide code rates decreased from 11.2 per 1,000 patients before team interventions to 7.5 cardiac arrests per 1,000 patients after the team was operating. However, this decrease isn't statistically significant and "was not associated with a reduction in the primary end point of hospital-wide code rates[horizontal ellipsis]although lower rates of non-ICU codes were observed." Hospital-wide mortality before and after the team was implemented was also unchanged.
Researchers say they found no evidence of undertreatment or underuse of the rapid response team that might explain these findings. Their conclusions raise questions about whether hospitals should be devoting substantial resources to rapid response teams.
Source: Chan PS, Khalid A, Longmore LS, Berg RA, Kosiborod M, Spertus JA. Hospital-wide code rates and mortality before and after implementation of a rapid response team. JAMA. 2008;300(21):2506-2513
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