title: Impact of proactive rounding by a rapid response team on patient outcomes at an academic medical center.
abstract: BACKGROUND
  The impact of rapid response teams (RRT) on patient outcomes remains uncertain.
  
  
  OBJECTIVE
  To examine the effect of proactive rounding by an RRT on outcomes of hospitalized adults discharged from intensive care.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  All adult patients discharged alive from the intensive care unit (ICU) at the University of California San Francisco Medical Center between January 2006 and June 2009.
  
  
  METHODS
  Introduction of proactive rounding by an RRT.
  
  
  METHODS
  Outcomes included the ICU readmission rate, ICU average length of stay (LOS), and in-hospital mortality of patients discharged from the ICU. Data were obtained from administrative billing databases and analyzed using an interrupted time series (ITS) model.
  
  
  RESULTS
  We analyzed 17 months of preintervention data and 25 months of postintervention data. Introduction of proactive rounding by the RRT did not change the ICU readmission rate (6.7% before vs 7.3% after; P = 0.24), the ICU LOS (5.1 days vs 4.9 days; P = 0.24), or the in-hospital mortality of patients discharged from the ICU (6.0% vs 5.5%; P = 0.24). ITS models testing the impact of proactive rounding on secular trends found no improvement in any of the 3 clinical outcomes relative to their preintervention trends.
  
  
  CONCLUSIONS
  Proactive rounding by an RRT did not improve patient outcomes, raising further questions about RRT benefits.
authors.affiliation: Department of Medicine, Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA. brad.butcher@ucsf.edu
authors.forename: Brad W
authors.initials: BW
authors.lastname: Butcher
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Judith
authors.initials: J
authors.lastname: Maselli
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Auerbach
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012495:San Francisco