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Rapid Response Teams to the Rescue

At Howard County General, ICU nurse Maureen Shirtliff rushes to a patient’s bedside. (Photo: Jill Meyers)

A nurse on the intermediate care unit at Howard County General Hospital is concerned about a seriously ill patient whose condition is worsening. Unlike a big teaching hospital, Howard County General has no fleet of residents to help when things go awry. So this nurse will call the attending physician, who may be in an office several miles away.

That, at least, is what would have happened last year. This year, thanks to the hospital’s new rapid response teams, help will be on the way in a matter of minutes.

Rapid response teams are teams of clinicians who rush to the bedside at the first sign of trouble. At Howard County General, they consist of a hospitalist physician, ICU nurse and respiratory therapist. The service rolled out last April, first in the intermediate care unit. By mid-July, the teams were available to all units.

Last month came the first quality measurements. The data indicate that codes decreased among adult inpatients outside the ICU and that the number of codes per 1,000 discharges also dropped. Nurses also are expressing high satisfaction with the teams.

It’s too early to tell how effective rapid response teams will be over the long term. “But for now, these data are promising and positive. We’re saving lives!” exclaims Judy Brown, senior vice president for patient care services.

The teams got their start in Australia and then gained favor in the United States, especially since becoming a key component of the “100,000 Lives Campaign,” launched in 2004 by the Institute for Healthcare Improvement, a nonprofit organization based in Cambridge, Mass.

Howard County General sees between eight and 20 calls a month for the teams, which spend about a half hour at the bedside, on average. Patients are either stabilized or transferred to the ICU.

The teams are sometimes known as “pre-code” teams, for they aim to avert a “code,” or cardiac arrest. “When codes happen, outcomes are usually quite poor,” Brown explains. “This program stops the patient’s downward cycle. It’s a good thing—especially for a community hospital like ours.

—Anne Bennett Swingle



Johns Hopkins Medicine

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