title: A novel configuration of a traditional rapid response team decreases non-intensive care unit arrests and overall hospital mortality.
abstract: BACKGROUND
  In-hospital cardiopulmonary arrest (CPA) accounts for substantial morbidity and mortality. Rapid response teams (RRTs) are designed to prevent non-intensive care unit (ICU) CPA through early detection and intervention. However, existing evidence has not consistently demonstrated a clear benefit.
  
  
  OBJECTIVE
  To explore the effectiveness of a novel RRT program design to decrease non-ICU CPA and overall hospital mortality.
  
  
  METHODS
  This study was conducted from the start of fiscal year 2005 to 2011. In November 2007, our hospitals implemented RRTs as part of a novel resuscitation program. Charge nurses from each inpatient unit underwent training as unit-specific RRT members. Additionally, all inpatient staff received annual training in RRT concepts including surveillance and recognition of deterioration. We compared the incidence of ICU and non-ICU CPA from first complete preimplementation year 2006 to postimplementation years 2007 to 2011. Overall hospital mortality was also reported.
  
  
  RESULTS
  The incidence of non-ICU CPA decreased, whereas the incidence of ICU CPA remained unchanged. Overall hospital mortality also decreased (2.12% to 1.74%, P < 0.001). The year-over-year change in RRT activations was inversely related to the change in Code Blue activations for each inpatient unit (r = -0.68, P < 0.001).
  
  
  CONCLUSIONS
  Our novel RRT program was associated with a decreased incidence of non-ICU CPA and improved hospital mortality.
authors.affiliation: Department of Emergency Medicine, University of California-San Diego, San Diego, California.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Davis
authors.affiliation: Department of Emergency Medicine, University of California-San Diego, San Diego, California.
authors.forename: Steve A
authors.initials: SA
authors.lastname: Aguilar
authors.affiliation: Department of Nursing Education, Development, Research, University of California-San Diego, San Diego, California.
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Graham
authors.affiliation: Department of Nursing, University of California-San Diego, San Diego, California.
authors.forename: Brenna
authors.initials: B
authors.lastname: Lawrence
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California-San Diego, San Diego, California.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Sell
authors.affiliation: Department of Anesthesiology, University of California-San Diego, San Diego, California.
authors.forename: Anushirvan
authors.initials: A
authors.lastname: Minokadeh
authors.affiliation: Division of Cardiology, University of California-San Diego, San Diego, California, and the Division of Cardiology, The Ohio State University, Columbus, Ohio.
authors.forename: Ruchika D
authors.initials: RD
authors.lastname: Husa
mesh_terms: D002140:California; D064648:Critical Care Nursing / Q000193:education*; D042241:Early Diagnosis; D006323:Heart Arrest / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D017052:Hospital Mortality / Q000639:trends*; D057209:Hospital Rapid Response Team / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D006785:Hospitals, University / Q000458:organization & administration / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007318:Inservice Training / Q000379:methods / Q000458:organization & administration; D017146:Models, Organizational; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D012138:Respiratory Therapy / Q000193:education*