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Dedicated rapid response teams yield better outcomes for in-hospital cardiac arrest
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The hospitals with the best outcomes for in-hospital cardiac arrest were, compared with other hospitals, more likely to have rapid response teams without competing clinical responsibilities, according to findings published in JAMA Internal Medicine.
The researchers analyzed data based on interviews with 158 hospital staff members from nine institutions participating in the Get With the Guidelines-Resuscitation program.
The participants included 45.6% nurses, 17.1% physicians, 17.1% clinical staff and 20.3% administrators.
Compared with other sites, top-performing sites differed in the following ways: team design and composition, rapid response team engagement in surveillance of patients at risk for cardiac arrest, empowerment of bedside nurses to activate the rapid response team and collaboration with bedside nurses during and after a rapid response, Kimberly Dukes, PhD, associate director for evaluation research at the University of Iowa’s Institute for Clinical and Translational Science, and colleagues wrote.
Dukes and colleagues also found that the top-performing hospitals tended to staff their rapid response teams with dedicated team members who had no competing clinical responsibilities, who were able to advise nurses on care of patients at risk for cardiac arrest and who collaborated with nurses during and after a rapid response.
The top-performing hospitals also allowed bedside nurses to activate rapid response teams without fear of reprisal from anyone else, according to the researchers.
Rapid response team members not at top-performing hospitals tended to have competing clinical responsibilities and be less engaged with bedside nurses, Dukes and colleagues wrote.
In addition, they wrote, nurses not at top-performing hospitals expressed concern about consequences from activating the rapid response team.
“In this large qualitative study of nine hospitals participating in [Get With the Guidelines]-Resuscitation,
we identified important differences in [rapid response team] structure and function between top-performing and non-top-performing sites in [in-hospital cardiac arrest] survival,” Dukes and colleagues wrote. “Several of our findings merit further discussion.” – by Erik Swain
Disclosures: Dukes reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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