Exploration of a rapid response team model of care: A descriptive dual methods study.

Shiell, A; Fry, M; Elliott, D; Elliott, R

Exploration of a rapid response team model of care: A descriptive dual methods study.

Shiell, A Fry, M

Elliott, D

Elliott, R

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Intensive and Critical Care Nursing, 2022, 73, pp. 1-8
Issue Date:: 2022-12

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Field	Value	Language
dc.contributor.author	Shiell, A
dc.contributor.author	Fry, M https://orcid.org/0000-0003-1265-7096
dc.contributor.author	Elliott, D https://orcid.org/0000-0002-6081-5442
dc.contributor.author	Elliott, R https://orcid.org/0000-0002-9239-7126
dc.date.accessioned	2022-11-09T02:42:04Z
dc.date.available	2022-06-26
dc.date.available	2022-11-09T02:42:04Z
dc.date.issued	2022-12
dc.identifier.citation	Intensive and Critical Care Nursing, 2022, 73, pp. 1-8
dc.identifier.issn	0964-3397
dc.identifier.issn	1532-4036
dc.identifier.uri	http://hdl.handle.net/10453/163356
dc.description.abstract	BACKGROUND: Avoidable in-patient clinical deterioration results in serious adverse events and up to 80% are preventable. Rapid response systems allow early recognition and response to clinical deterioration. OBJECTIVE: To explore the characteristics of a collaborative rapid response team model. DESIGN: Dual methodology was used for this descriptive study. SETTING: The study was conducted in a 500-bed tertiary referral hospital (Sydney, Australia). PARTICIPANTS: Inpatients (>17 years) who received a rapid response team activation were included in an electronic medical audit. Participants were rapid response team members and nurses and medical doctors in two in-patient wards. METHODS: A 12-month (January-December 2018) retrospective electronic health record audit and semi-structured interviews with nurses and medical doctors (July-August 2019) were conducted. Descriptive statistics summarised audit data. Interviews were transcribed and analysed thematically. RESULTS: The rapid response team consulted for 2195 patients. Mean patient age was 67.9 years, and 46% of the sample was female. Activations (n = 4092) occurred most often in general medicine (n = 1124, 70.8%) units. Overall, 117 patients had >5 activations. The themes synthesised from interviews were i) managing patient deterioration before arrival of the rapid response team; ii) collaboratively managing patient deterioration at the bedside; iii) rapid response team guidance at the bedside; and iv) 'staff concern' rapid response activation. CONCLUSIONS: Some patients received many activations, however few required treatment in critical care. The rapid response model was collaborative and supportive. The themes revealed a focus on patient safety, optimising early detection, and management of patient deterioration.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Intensive and Critical Care Nursing
dc.relation.isbasedon	10.1016/j.iccn.2022.103294
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing
dc.subject.classification	Nursing
dc.subject.mesh	Aged
dc.subject.mesh	Australia
dc.subject.mesh	Clinical Deterioration
dc.subject.mesh	Female
dc.subject.mesh	Hospital Rapid Response Team
dc.subject.mesh	Humans
dc.subject.mesh	Patient Safety
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Aged
dc.subject.mesh	Australia
dc.subject.mesh	Clinical Deterioration
dc.subject.mesh	Female
dc.subject.mesh	Hospital Rapid Response Team
dc.subject.mesh	Humans
dc.subject.mesh	Patient Safety
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Humans
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Aged
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Hospital Rapid Response Team
dc.subject.mesh	Patient Safety
dc.subject.mesh	Clinical Deterioration
dc.title	Exploration of a rapid response team model of care: A descriptive dual methods study.
dc.type	Journal Article
utslib.citation.volume	73
utslib.location.activity	Netherlands
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-11-09T02:42:03Z
pubs.publication-status	Published
pubs.volume	73

Abstract:

BACKGROUND: Avoidable in-patient clinical deterioration results in serious adverse events and up to 80% are preventable. Rapid response systems allow early recognition and response to clinical deterioration. OBJECTIVE: To explore the characteristics of a collaborative rapid response team model. DESIGN: Dual methodology was used for this descriptive study. SETTING: The study was conducted in a 500-bed tertiary referral hospital (Sydney, Australia). PARTICIPANTS: Inpatients (>17 years) who received a rapid response team activation were included in an electronic medical audit. Participants were rapid response team members and nurses and medical doctors in two in-patient wards. METHODS: A 12-month (January-December 2018) retrospective electronic health record audit and semi-structured interviews with nurses and medical doctors (July-August 2019) were conducted. Descriptive statistics summarised audit data. Interviews were transcribed and analysed thematically. RESULTS: The rapid response team consulted for 2195 patients. Mean patient age was 67.9 years, and 46% of the sample was female. Activations (n = 4092) occurred most often in general medicine (n = 1124, 70.8%) units. Overall, 117 patients had >5 activations. The themes synthesised from interviews were i) managing patient deterioration before arrival of the rapid response team; ii) collaboratively managing patient deterioration at the bedside; iii) rapid response team guidance at the bedside; and iv) 'staff concern' rapid response activation. CONCLUSIONS: Some patients received many activations, however few required treatment in critical care. The rapid response model was collaborative and supportive. The themes revealed a focus on patient safety, optimising early detection, and management of patient deterioration.

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http://hdl.handle.net/10453/163356