Evidence-based medicine and rapid response team implementation.
The implementation of Rapid Response Teams is becoming commonplace in U.S. hospitals, following the model developed in Australia. The Rapid Response Team is a method of bringing ICU-level patient care to the bedside of critically ill patients using a multidisciplinary team. Acute care unit staff are trained to recognize clinical deterioration using a set of vital sign calling criteria (systolic blood pressure below 90 mmHg, pulse below 60 or above 100, etc.). Many hospitals have been facing problems gaining needed support to make the organizational changes needed for the team to function properly. Some faculty physicians have expressed apprehension about losing control over their patients, and they have also highlighted the lack of rigorous experimental evidence that the teams work. Since there are so many confounding factors at work when trying to design an experimental study of this type of change, the study may not accurately portray the situation. Other evaluation methods should therefore be considered.
Bruckel
Jeffrey
J
University of North Carolina Hospitals, Department of Continuous Quality Improvement, NC, USA. bruckel@email.unc.edu