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==Effectiveness== |
==Effectiveness== |
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Rapid response teams appear to decrease the rates of [[respiratory arrest|respiratory]] and [[cardiac arrest]] outside the intensive care unit.<ref name=Chan2010>{{cite journal|last=Chan|first=PS|author2=Jain, R |author3=Nallmothu, BK |author4=Berg, RA |author5=Sasson, C |title=Rapid Response Teams: A Systematic Review and Meta-analysis.|journal=Archives of Internal Medicine|date=2010-01-11|volume=170|issue=1|pages=18–26|pmid=20065195|doi=10.1001/archinternmed.2009.424}}</ref><ref>{{cite journal|last=Winters|first=BD|author2=Weaver, SJ |author3=Pfoh, ER |author4=Yang, T |author5=Pham, JC |author6= Dy, SM |title=Rapid-response systems as a patient safety strategy: a systematic review.|journal=Annals of Internal Medicine|date=Mar 5, 2013|volume=158|issue=5 Pt 2|pages=417–25|pmid=23460099|doi=10.7326/0003-4819-158-5-201303051-00009}}</ref><ref>{{cite journal|last1=Kronick|first1=SL|last2=Kurz|first2=MC|last3=Lin|first3=S|last4=Edelson|first4=DP|last5=Berg|first5=RA|last6=Billi|first6=JE|last7=Cabanas|first7=JG|last8=Cone|first8=DC|last9=Diercks|first9=DB|last10=Foster|first10=JJ|last11=Meeks|first11=RA|last12=Travers|first12=AH|last13=Welsford|first13=M|title=Part 4: Systems of Care and Continuous Quality Improvement: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.|journal=Circulation|date=3 November 2015|volume=132|issue=18 Suppl 2|pages=S397-413|pmid=26472992|doi=10.1161/cir.0000000000000258}}</ref> They also appear to decrease the chance of death in hospital.<ref>{{cite journal|last1=Solomon|first1=RS|last2=Corwin|first2=GS|last3=Barclay|first3=DC|last4=Quddusi|first4=SF|last5=Dannenberg|first5=MD|title=Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality: A systematic review and meta-analysis.|journal=Journal of hospital medicine|date=June 2016|volume=11|issue=6|pages=438–445|pmid=26828644|doi=10.1002/jhm.2554}}</ref> Overall effectiveness of RRTs is somewhat controversial due to the variability across studies.<ref name=Chan2010/><ref>{{cite journal|last=Hillman|first=K|author2=Chen, J |author3=Cretikos, M |author4=Bellomo, R |author5=Brown, D |author6=Doig, G |author7=Finfer, S |author8=Flabouris, A |author9= MERIT study, investigators |title=Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial.|journal=Lancet|date=Jun 18–24, 2005|volume=365|issue=9477|pages=2091–7|pmid=15964445|doi=10.1016/S0140-6736(05)66733-5}}</ref><ref>{{cite journal|last=Massey|first=D|author2=Aitken, LM |author3=Chaboyer, W |title=Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient?|journal=Journal of clinical nursing|date=Dec 2010|volume=19|issue=23-24|pages=3260–73|pmid=21029228|doi=10.1111/j.1365-2702.2010.03394.x}}</ref><ref>{{cite journal|last=Ranji|first=SR|author2=Auerbach, AD |author3=Hurd, CJ |author4=O'Rourke, K |author5= Shojania, KG |title=Effects of rapid response systems on clinical outcomes: systematic review and meta-analysis.|journal=Journal of Hospital Medicine|date=Nov 2007|volume=2|issue=6|pages=422–32|pmid=18081187|doi=10.1002/jhm.238}}</ref><ref>{{cite journal|last=Tibballs|first=J|author2=van der Jagt, EW|title=Medical emergency and rapid response teams.|journal=Pediatric clinics of North America|date=Aug 2008|volume=55|issue=4|pages=989–1010, xi|pmid=18675030|doi=10.1016/j.pcl.2008.04.006}}</ref><ref>{{cite journal|last=Winters|first=BD|author2=Pham, JC |author3=Hunt, EA |author4=Guallar, E |author5=Berenholtz, S |author6= Pronovost, PJ |title=Rapid response systems: a systematic review.|journal=Critical Care Medicine|date=May 2007|volume=35|issue=5|pages=1238–43|pmid=17414079|doi=10.1097/01.CCM.0000262388.85669.68}}</ref><ref>{{cite journal|last=Stahel|first=PF|author2=Fakler, JK |author3=Flierl, MA |author4=Moldenhauer, K |author5= Mehler, PS |title=[Current concepts of patient safety: rapid response system].|journal=Der Unfallchirurg|date=Mar 2010|volume=113|issue=3|pages=239–46|pmid=20174916|doi=10.1007/s00113-009-1734-7}}</ref> |
Rapid response teams appear to decrease the rates of [[respiratory arrest|respiratory]] and [[cardiac arrest]] outside the intensive care unit.<ref name=Chan2010>{{cite journal|last=Chan|first=PS|author2=Jain, R |author3=Nallmothu, BK |author4=Berg, RA |author5=Sasson, C |title=Rapid Response Teams: A Systematic Review and Meta-analysis.|journal=Archives of Internal Medicine|date=2010-01-11|volume=170|issue=1|pages=18–26|pmid=20065195|doi=10.1001/archinternmed.2009.424}}</ref><ref>{{cite journal|last=Winters|first=BD|author2=Weaver, SJ |author3=Pfoh, ER |author4=Yang, T |author5=Pham, JC |author6= Dy, SM |title=Rapid-response systems as a patient safety strategy: a systematic review.|journal=Annals of Internal Medicine|date=Mar 5, 2013|volume=158|issue=5 Pt 2|pages=417–25|pmid=23460099|doi=10.7326/0003-4819-158-5-201303051-00009}}</ref><ref>{{cite journal|last1=Kronick|first1=SL|last2=Kurz|first2=MC|last3=Lin|first3=S|last4=Edelson|first4=DP|last5=Berg|first5=RA|last6=Billi|first6=JE|last7=Cabanas|first7=JG|last8=Cone|first8=DC|last9=Diercks|first9=DB|last10=Foster|first10=JJ|last11=Meeks|first11=RA|last12=Travers|first12=AH|last13=Welsford|first13=M|title=Part 4: Systems of Care and Continuous Quality Improvement: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.|journal=Circulation|date=3 November 2015|volume=132|issue=18 Suppl 2|pages=S397-413|pmid=26472992|doi=10.1161/cir.0000000000000258}}</ref> They also appear to decrease the chance of death in hospital.<ref>{{cite journal|last1=Solomon|first1=RS|last2=Corwin|first2=GS|last3=Barclay|first3=DC|last4=Quddusi|first4=SF|last5=Dannenberg|first5=MD|title=Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality: A systematic review and meta-analysis.|journal=Journal of hospital medicine|date=June 2016|volume=11|issue=6|pages=438–445|pmid=26828644|doi=10.1002/jhm.2554}}</ref> An evidence-based review found that success of rapid response teams was dependent on the quality of implementation and noted the success of the York protocol, which incorporated education, support, and practical help for clinical staff. <ref>Belknap SM. ACP Journal Club. Review: Rapid-response teams do not reduce mortality in hospital patients. Ann Intern Med. 2010 Jun 15;152(12):JC6-3. doi: 10.7326/0003-4819-152-12-201006150-02003. No abstract available. PMID: 20547897</ref> Overall effectiveness of RRTs is somewhat controversial due to the variability across studies.<ref name=Chan2010/><ref>{{cite journal|last=Hillman|first=K|author2=Chen, J |author3=Cretikos, M |author4=Bellomo, R |author5=Brown, D |author6=Doig, G |author7=Finfer, S |author8=Flabouris, A |author9= MERIT study, investigators |title=Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial.|journal=Lancet|date=Jun 18–24, 2005|volume=365|issue=9477|pages=2091–7|pmid=15964445|doi=10.1016/S0140-6736(05)66733-5}}</ref><ref>{{cite journal|last=Massey|first=D|author2=Aitken, LM |author3=Chaboyer, W |title=Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient?|journal=Journal of clinical nursing|date=Dec 2010|volume=19|issue=23-24|pages=3260–73|pmid=21029228|doi=10.1111/j.1365-2702.2010.03394.x}}</ref><ref>{{cite journal|last=Ranji|first=SR|author2=Auerbach, AD |author3=Hurd, CJ |author4=O'Rourke, K |author5= Shojania, KG |title=Effects of rapid response systems on clinical outcomes: systematic review and meta-analysis.|journal=Journal of Hospital Medicine|date=Nov 2007|volume=2|issue=6|pages=422–32|pmid=18081187|doi=10.1002/jhm.238}}</ref><ref>{{cite journal|last=Tibballs|first=J|author2=van der Jagt, EW|title=Medical emergency and rapid response teams.|journal=Pediatric clinics of North America|date=Aug 2008|volume=55|issue=4|pages=989–1010, xi|pmid=18675030|doi=10.1016/j.pcl.2008.04.006}}</ref><ref>{{cite journal|last=Winters|first=BD|author2=Pham, JC |author3=Hunt, EA |author4=Guallar, E |author5=Berenholtz, S |author6= Pronovost, PJ |title=Rapid response systems: a systematic review.|journal=Critical Care Medicine|date=May 2007|volume=35|issue=5|pages=1238–43|pmid=17414079|doi=10.1097/01.CCM.0000262388.85669.68}}</ref><ref>{{cite journal|last=Stahel|first=PF|author2=Fakler, JK |author3=Flierl, MA |author4=Moldenhauer, K |author5= Mehler, PS |title=[Current concepts of patient safety: rapid response system].|journal=Der Unfallchirurg|date=Mar 2010|volume=113|issue=3|pages=239–46|pmid=20174916|doi=10.1007/s00113-009-1734-7}}</ref> |
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==References== |
==References== |
Revision as of 19:57, 16 March 2017
Rapid response team | |
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Pronunciation | medical emergency team, high acuity response team |
A rapid response team (RRT), also known as a medical emergency team (MET) is a team of health care providers that responds to hospitalized patients with early signs of clinical deterioration on non-intensive care units to prevent respiratory or cardiac arrest. The health care providers are trained in early resuscitation interventions and advanced life support and often include a physician, nurse, and respiratory therapist. The RRT, medical emergency team (MET), critical care outreach team (CCOT), and rover team are all different forms of the efferent component of the rapid response system. The team responds to calls placed by clinicians or families at the bedside who have detected deterioration.[1][2][3]
Effectiveness
Rapid response teams appear to decrease the rates of respiratory and cardiac arrest outside the intensive care unit.[4][5][6] They also appear to decrease the chance of death in hospital.[7] An evidence-based review found that success of rapid response teams was dependent on the quality of implementation and noted the success of the York protocol, which incorporated education, support, and practical help for clinical staff. [8] Overall effectiveness of RRTs is somewhat controversial due to the variability across studies.[4][9][10][11][12][13][14]
References
- ^ Jones, DA; DeVita, MA; Bellomo, R (Jul 14, 2011). "Rapid-response teams" (PDF). The New England Journal of Medicine. 365 (2): 139–46. doi:10.1056/NEJMra0910926. PMID 21751906.
- ^ Devita, MA; Bellomo, R; Hillman, K; Kellum, J; Rotondi, A; Teres, D; Auerbach, A; Chen, WJ; Duncan, K; Kenward, G; Bell, M; Buist, M; Chen, J; Bion, J; Kirby, A; Lighthall, G; Ovreveit, J; Braithwaite, RS; Gosbee, J; Milbrandt, E; Peberdy, M; Savitz, L; Young, L; Harvey, M; Galhotra, S (Sep 2006). "Findings of the first consensus conference on medical emergency teams". Critical Care Medicine. 34 (9): 2463–78. doi:10.1097/01.CCM.0000235743.38172.6E. PMID 16878033.
- ^ National Institute for Health and Clinical Excellence. Clinical guideline 50: Acutely ill patients in hospital. London, 2007.
- ^ a b Chan, PS; Jain, R; Nallmothu, BK; Berg, RA; Sasson, C (2010-01-11). "Rapid Response Teams: A Systematic Review and Meta-analysis". Archives of Internal Medicine. 170 (1): 18–26. doi:10.1001/archinternmed.2009.424. PMID 20065195.
- ^ Winters, BD; Weaver, SJ; Pfoh, ER; Yang, T; Pham, JC; Dy, SM (Mar 5, 2013). "Rapid-response systems as a patient safety strategy: a systematic review". Annals of Internal Medicine. 158 (5 Pt 2): 417–25. doi:10.7326/0003-4819-158-5-201303051-00009. PMID 23460099.
- ^ Kronick, SL; Kurz, MC; Lin, S; Edelson, DP; Berg, RA; Billi, JE; Cabanas, JG; Cone, DC; Diercks, DB; Foster, JJ; Meeks, RA; Travers, AH; Welsford, M (3 November 2015). "Part 4: Systems of Care and Continuous Quality Improvement: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S397-413. doi:10.1161/cir.0000000000000258. PMID 26472992.
- ^ Solomon, RS; Corwin, GS; Barclay, DC; Quddusi, SF; Dannenberg, MD (June 2016). "Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality: A systematic review and meta-analysis". Journal of hospital medicine. 11 (6): 438–445. doi:10.1002/jhm.2554. PMID 26828644.
- ^ Belknap SM. ACP Journal Club. Review: Rapid-response teams do not reduce mortality in hospital patients. Ann Intern Med. 2010 Jun 15;152(12):JC6-3. doi: 10.7326/0003-4819-152-12-201006150-02003. No abstract available. PMID: 20547897
- ^ Hillman, K; Chen, J; Cretikos, M; Bellomo, R; Brown, D; Doig, G; Finfer, S; Flabouris, A; MERIT study, investigators (Jun 18–24, 2005). "Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial". Lancet. 365 (9477): 2091–7. doi:10.1016/S0140-6736(05)66733-5. PMID 15964445.
- ^ Massey, D; Aitken, LM; Chaboyer, W (Dec 2010). "Literature review: do rapid response systems reduce the incidence of major adverse events in the deteriorating ward patient?". Journal of clinical nursing. 19 (23–24): 3260–73. doi:10.1111/j.1365-2702.2010.03394.x. PMID 21029228.
- ^ Ranji, SR; Auerbach, AD; Hurd, CJ; O'Rourke, K; Shojania, KG (Nov 2007). "Effects of rapid response systems on clinical outcomes: systematic review and meta-analysis". Journal of Hospital Medicine. 2 (6): 422–32. doi:10.1002/jhm.238. PMID 18081187.
- ^ Tibballs, J; van der Jagt, EW (Aug 2008). "Medical emergency and rapid response teams". Pediatric clinics of North America. 55 (4): 989–1010, xi. doi:10.1016/j.pcl.2008.04.006. PMID 18675030.
- ^ Winters, BD; Pham, JC; Hunt, EA; Guallar, E; Berenholtz, S; Pronovost, PJ (May 2007). "Rapid response systems: a systematic review". Critical Care Medicine. 35 (5): 1238–43. doi:10.1097/01.CCM.0000262388.85669.68. PMID 17414079.
- ^ Stahel, PF; Fakler, JK; Flierl, MA; Moldenhauer, K; Mehler, PS (Mar 2010). "[Current concepts of patient safety: rapid response system]". Der Unfallchirurg. 113 (3): 239–46. doi:10.1007/s00113-009-1734-7. PMID 20174916.