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BWH rolled out Rapid Response System (RRS) programs on several non-ICU inpatient units in October, November and December, and plans are in place to extend RRS coverage to all non-ICU inpatient units by March.
Rapid response systems (RRSs) provide multidisciplinary clinical responders 24-hours-a-day to deliver immediate bedside care for deteriorating non-ICU patients and to initiate interventions to prevent further deterioration. RRS at BWH calls for any bedside clinical staff to page a first-responding physician (the primary or covering intern, physician assistant or surgeon) and to notify the RRS critical care nurse and respiratory therapist when a patient exhibits signs of deterioration. The pages to these RRS clinicians will take priority and trigger an urgent response.
“Delayed or suboptimal intervention for inpatients with unexpected clinical deterioration is an important and not uncommon clinical problem associated with increased morbidity and mortality,” said Jeffrey M. Rothschild, MD, of the Department of Medicine and physician co-chair in the roll out of RRS at BWH. “Data from our first few months suggest that the RRS is improving patient care.”
Since its initiation in October, the RRS has been activated more than 45 times. The Center for Clinical Excellence will analyze data relative to RRS, and that data will be reported to the Emergency Response Committee.
In one instance, Donna Cook, RN, a clinical staff nurse, noticed her elderly patient was developing respiratory distress. She called in the RRS team, and in minutes, the physician evaluated the patient and prescribed a diuretic and CPAP to assist the patient’s breathing for a short time.
“In about an hour, the patient was breathing easier on her own and much more comfortable in her room, not an ICU,” Jan McGrath, MHA, BSN, RN, nurse manager, Tower 15AB, said. “With one call to telecommunications, a page goes out to the RRS clinicians including physicians, PAs a respiratory therapist and a critical care nurse.”
Diane Lancaster, PhD, RN, director of Quality Measurement & Improvement in the Department of Nursing and co-chair of the RRS implementation team, has been working with Nursing leadership to roll out the RRS. “The system provides clinical nurses with the infrastructure necessary to obtain a quick response to signs of clinical deterioration much earlier in the patient’s course,” she added.
‘Rapid Response System: Updates on 2009 Go Live,’ is Tuesday, Jan. 13, noon to 1 p.m. in the Anesthesia Conference Room, CWN-L1. Lunch will be served at 11:45 a.m.