Hospitals urged to develop rapid-response teams.(Practice Trends)

CHICAGO -- Expanded use of rapid-response teams should be a key element in efforts to reduce hospital mortality, speakers said at the annual meeting of the Society of Hospital Medicine.

"Few of us get good team training," said John Whittington, M.D., coordinator of clinical informatics and patient safety officer at OSF Healthcare System in Peoria, Ill. "A rapid-response team of clinicians brings critical care expertise to the bedside, where they can assess, stabilize, improve communication, educate, support and assist with patient transfer when necessary."

Development of rapid-response teams is a cornerstone of the systems-based approach advocated by the "100,000 Lives Campaign" of the Institute for Healthcare Improvement, Cambridge, Mass. Supported by the American Medical Association and other private and public sector health care organizations, the campaign aims to prevent 100,000 unintended deaths by June 2006.

Other goals of the 100,000 Lives Campaign include delivery of evidence-based care for patients with acute myocardial infarction, implementation of "medication reconciliation" to prevent prescribing errors, and use of science-based methods to prevent central-line infections, ventilator-associated pneumonia, and surgical-site infections.

More than 2,000 hospitals have joined the effort, Dr. Whittington said. "We decided that instead of a disease-specific focus, we'd go to a systems-specific focus to float the whole boat." By improving teamwork and communications, "you can improve the whole situation in a hospital."

"We can achieve a significant drop in all-cause mortality" by using these teams, he said. "You also see a significant drop in code rate per 1,000 discharges." By improving outcomes, relationships, and job satisfaction, rapid-response teams also may boost employee retention levels and reduce costs.

Dr. Whittington cited an Australian study showing that 76% of cardiac arrests followed more than 1 hour of ongoing instability (Med. J. Aust. 1999;171:22-5). This and other studies identifying missed warning signs show that there are "burning opportunities" for rapid-response teamwork in hospitals, he said.