title: Analysis of readmission rates to the intensive care unit after implementation of a rapid response team in a University Hospital.
abstract: OBJECTIVE
  To compare readmission rates to the intensive care unit (ICU) before and after the implementation of a rapid response team (RRT), and to identify risk factors for readmission.
  
  
  METHODS
  A quasi-experimental before-after study was carried out.
  
  
  METHODS
  A University Hospital.
  
  
  METHODS
  All patients discharged from the ICU from January to December 2008 (control group) and from January 2010 to December 2012 (intervention group).
  
  
  METHODS
  Implementation of an RRT.
  
  
  METHODS
  The data included demographic parameters, diagnoses upon admission, ICU readmission, APACHE II, SOFA, and TISS 28 scores, and routine daily assessment by an RRT of patients discharged from the ICU.
  
  
  RESULTS
  During the study interval, 380 patients were analyzed in the period prior to the implementation of the RRT and 1361 after implementation. There was a tendency toward decreased readmission rates one year after RRT implementation. The APACHE II score and SOFA score at ICU discharge were independent factors associated to readmission, as well as clinical referral to the ICU.
  
  
  CONCLUSIONS
  The RRT intervention resulted in a sustained decrease in readmission rates one year after implementation of this service. The use of a specialized team in health institutions can be recommended for ICU survivors.
authors.affiliation: Intensive Care Division, Hospital Universitário Regional do Norte do Paraná, Universidade Estadual de Londrina, Rua Robert Koch 60, Vila Operária, Londrina, Paraná 86038-440, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Bergamasco E Paula
authors.affiliation: Intensive Care Division, Hospital Universitário Regional do Norte do Paraná, Universidade Estadual de Londrina, Rua Robert Koch 60, Vila Operária, Londrina, Paraná 86038-440, Brazil.
authors.forename: M T
authors.initials: MT
authors.lastname: Tanita
authors.affiliation: Department of Clinical Medical, Universidade Estadual de Londrina, Rua Robert Koch 60, Vila Operária, Londrina, Paraná 86038-440, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Festti
authors.affiliation: Department of Clinical Medical, Universidade Estadual de Londrina, Rua Robert Koch 60, Vila Operária, Londrina, Paraná 86038-440, Brazil.
authors.forename: L T
authors.initials: LT
authors.lastname: Queiroz Cardoso
authors.affiliation: Department of Clinical Medical, Universidade Estadual de Londrina, Rua Robert Koch 60, Vila Operária, Londrina, Paraná 86038-440, Brazil. Electronic address: cintiagrion@hotmail.com.
authors.forename: C M
authors.initials: CM
authors.lastname: Carvalho Grion
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D001938:Brazil; D065187:Controlled Before-After Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006779:Hospitals, Public / Q000458:organization & administration; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D010348:Patient Care Team; D010359:Patient Readmission / Q000706:statistics & numerical data* / Q000639:trends; D012372:ROC Curve
keywords: Equipo Hospitalario de Respuesta Rápida; Indicadores de Calidad de la Atención de Salud; Intensive care units; Patient readmission; Quality indicators in health care; Rapid response team; Readmisión del Paciente; Unidades de Cuidados Intensivos