Rapid response team in an academic institution: does it make a difference?
BACKGROUND
Although data remain contradictory, rapid response systems are implemented across US hospitals. We aimed to determine whether implementation of a rapid response team (RRT) in a tertiary academic hospital improved outcomes.


METHODS
Our hospital is a tertiary academic medical center with 24-h in-house resident coverage. We conducted a retrospective cohort study comparing 27 months after implementation of the RRT (April 1, 2006, to June 31, 2008) and 9 months before (January 1, 2005, to September 31, 2005). Outcomes included incidence of codes (cardiac and/or respiratory arrests), outcome of the codes, and overall hospital mortality.


RESULTS
We analyzed 16,244 nonobstetrics hospital admissions and 70,208 patient days in the control period and 45,145 nonobstetrics hospital admissions and 161,097 patient days after the RRT was implemented. The RRT was activated 1,206 times (7.7 calls per 1,000 patient days). There was no difference in the code rate (0.83 vs 0.98 per 1,000 patient days, P = .3). There was a modest but nonsustained improvement in nonobstetrics hospital mortality during the study period (2.40% vs 2.15%; P = .05), which could not be explained by the RRT effect on code rates. The mortality was 2.40% in the control group and 2.06%, 1.94%, and 2.46%, respectively, during the next three consecutive 9-month intervals.


CONCLUSIONS
In our single-institution study involving an academic hospital with 24-h in-house coverage, we found that RRT implementation did not reduce code rates in the 27 months after intervention. Although there was a decrease in overall hospital mortality, this decrease was small, nonsustained, and not explained by the RRT effect on code rates.
Shah
Shiwan K
SK
Departments of Internal Medicine and Pediatrics, University of Texas Medical Branch, Galveston, TX.
Cardenas
Victor J
VJ
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Texas Medical Branch, Galveston, TX.
Kuo
Yong-Fang
YF
Sealy Center on Aging, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX.
Sharma
Gulshan
G
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Texas Medical Branch, Galveston, TX; Sealy Center on Aging, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX. Electronic address: gulshan.sharma@utmb.edu.
D000328:Adult; D002648:Child; D003422:Critical Care / Q000458:organization & administration*; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy*; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D010043:Outcome and Process Assessment, Health Care; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies