March 23, 2009
Written with assistance from Joe Murphy, Public Affairs Officer, VA National Center for Patient Safety
Members of the Rapid Response Team (from left): Hyginus Osondu, M.P.A., R.R.T., Respiratory Care night shift supervisor; Veronica Magee, M.A., N.E.-B.C., R.N.-B.C., nurse executive; Barbara Marshall, M.Ed., R.R.T., Respiratory Care chief; Antonia Jodinskas, R.R.T., R.C.P., Respiratory Care day shift supervisor; Charlie Lan, D.O., Pulmonary Section staff physician; Louisa Ikpeama, R.N., A.C.N.P., Acute Care nurse practitioner; and Uselyn Deary, R.N., A.C.N.P., Acute Care nurse practitioner.
HOUSTON - Following a successful pilot program, a Rapid Response Team was put into action for inpatients at the Michael E. DeBakey VA Medical Center (MEDVAMC). The team includes a Medical/Neuro Step-Down nurse practitioner, a respiratory therapist, and a physician, usually the pulmonary fellow or the in-house resident after regular business hours.
Any health care provider who is worried about his or her patient has the ability to call the Rapid Response Team at the first sign of a patient decline. Within minutes, a team of professionals rush to the patient’s bedside in an attempt to reverse the patient’s instability.
The Rapid Response Team is called to respond to acute change in a patient’s status such as altered mental changes, new onset seizures, suspected stroke, acute change in heart rate or respiratory rate, uncontrolled bleeding, acute change in urinary output or temperature, and in general, staff or family concern that the patient does not look good.
“The Rapid Response Team is different from calling a ‘Code Blue,’ because the patient is just beginning to show signs of distress,” said Charlie Lan, D.O., Pulmonary Section staff physician and Rapid Response Team Leader. “Simply put, the purpose of the Rapid Response Team is to quickly bring critical care expertise to the patient’s bedside or wherever it is needed.”
When the Rapid Response Team is called, the team members assemble at the patient’s bedside in less than five minutes. Since the criteria used are very specific, an underlying problem usually can be identified quickly. The team discusses and carries out a treatment plan and monitors the disposition of the patient. The goal is for an overall improvement in the patient’s health.
The MEDVAMC’s Rapid Response Team concept also supports one of the Joint Commission’s National Patient Safety Goals. Goal 16 calls for improving “recognition and response to changes in a patient’s condition” and Requirement 16a states organizations should select “a suitable method that enables health care staff members to directly request additional assistance from specially trained individual(s) when the patient’s condition appears to be worsening.”
Furthermore, one of the implementation requirements for Goal 16 indicates an organization should empower “staff, patients, and/or families to request additional assistance when they have a concern about the patient’s condition,” which relates directly to Goal 13: “Encourage the active involvement of patients and their families in the patient’s own care as a patient safety strategy.”
To activate the Rapid Response Team for any of the early warning signs, dial ‘911’ from any MEDVAMC telephone.
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