title: Rapid response team implementation and in-hospital mortality*.
abstract: OBJECTIVE
  To determine the relationship between implementation of rapid response teams and improved mortality rate using a large, uniform dataset from one state in the United States.
  
  
  METHODS
  This observational cohort study included 471,062 adult patients hospitalized between 2001 and 2009.
  
  
  METHODS
  Ten acute tertiary care hospitals in Washington State.
  
  
  METHODS
  Hospital abstract records on adult patients (18 years old or older) were examined (n = 471,062). Patients most likely to benefit from rapid response team interventions were included and other prognostic factors of severity of illness and comorbidities were controlled. Each participating hospital provided the implementation date of their rapid response team intervention. Mortality rates in 31 months before rapid response team implementation (pre-rapid response team time period) were compared with mortality rates in 31 months following rapid response team implementation (post-rapid response team time period).
  
  
  METHODS
  Implementation of a rapid response team within each acute tertiary care hospital.
  
  
  RESULTS
  In-hospital mortality. Relative risk for in-hospital mortality improved in the post-rapid response team time period compared with the pre-rapid response team time period (relative risk = 0.76; 95% CI = 0.72-0.80; p < 0.001).
  
  
  CONCLUSIONS
  In-hospital mortality improved in six of 10 acute tertiary care hospitals in the post-rapid response team time period when compared with the pre-rapid response team time period. Because of a long-term trend of decline in hospital mortality, these decreases could not be unambiguously attributed to rapid response team implementation. Further research should examine additional objective outcomes and optimal configuration of rapid response teams to maximize intervention effectiveness.
authors.affiliation: 1College of Nursing, Seattle University, Seattle, WA. 2College of Nursing, Washington State University, Spokane, WA. 3Providence Medical Research Center, Providence Sacred Heart Medical Center, Spokane, WA. 4Department of Medical Education and Biomedical Informatics, University of Washington, Seattle, WA.
authors.forename: Gail
authors.initials: G
authors.lastname: Salvatierra
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Bindler
authors.forename: Cynthia
authors.initials: C
authors.lastname: Corbett
authors.forename: John
authors.initials: J
authors.lastname: Roll
authors.forename: Kenn B
authors.initials: KB
authors.lastname: Daratha
mesh_terms: D015897:Comorbidity; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends*; D057209:Hospital Rapid Response Team / Q000706:statistics & numerical data*; D006801:Humans; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*