Summary of "Effect of a Rapid Response Team on the Incidence of In-Hospital Mortality"

Summary published September 13, 2022

Summary by John W. Beard, MD

Anesthesia & Analgesia | February 2016

Jung B, Daurat A, De Jong A, et al. Rapid response team and hospital mortality in hospitalized patients. Intensive Care Med. 2016;42(4):494-504.

doi: https://doi.org/10.1007/s00134-016-4254-2

  • Rapid Response Teams (RRTs) are utilized in health care facilities to improve the outcomes for patients who experience in hospital emergencies. However, the evidence to support RRT effectiveness has been mixed.
  • In this single-center retrospective analysis conducted at the Cleveland Clinic, researchers reviewed in-patient mortality rates from March 2005 through December 2018. The analytic strategy evaluated the impact of the following interventions:
    • 2009 – RRT creation in Emergency Medicine nursing leadership
    • 2012 – RRT transition to Department of Anesthesiology leadership
    • 2014 – administrative changes affecting care of certain elevated risk patient groups
  • A total of 628,533 hospitalizations were included in the data set, 177,755 occurred before RRT introduction in 2009 and 450,778 occurred with the RRT in place.
    • Before 2009 (Prior to the RRT) – in hospital mortality was flat (odds ratio [95% CI] per year, 1.01 [0.98–1.04]; P = .60)
    • After 2009 (Post RRT introduction) – mortality declined modestly and progressively with an odds ratio per year of 0.961 (0.955-0.968)
      • 2009–2011 – in-hospital mortality did not change
      • 2012-2013 –a gradual significant decrease in mortality
      • 2014 – a more significant decrease in mortality
    • The authors conclude that the drivers of the mortality decrease are not clear but may include RRT program anesthesiologist leadership and administrative changes to reduce risk for specific populations. The authors also note that mortality benefits from a RRT program may take years to manifest as the team is implemented and integrated into clinical workflows.