CMH adds rapid response team A Code Blue for a medical emergency at Clinton Memorial Hospital sends a ripple of immediate action through the clinical team. Typically these codes are called when a patient's condition has deteriorated quickly to a cardiac or respiratory arrest.
CMH Regional Health System has recently put into action a special team focused on reducing Code Blue situations and improving patient care, according to James Burton, manager of Respiratory Care.
The Rapid Response Team (RRT) is composed of a diverse group of clinicians who bring critical care expertise immediately to the patient bedside. Their responses are intended to reduce adverse outcomes or deaths through early and effective interventions.
Adverse clinical events, cardiac and respiratory arrests, and other unanticipated medical emergencies are not infrequent events in hospitals. Many patients needing the aide of the RRT have clearly identifiable signs of deterioration prior to these events. Yet despite this, survival rates for events such as cardiac arrests are often less than 20 percent.
"The RRT's approach is to prevent a medical crisis before they happen, to rescue patients rather than resuscitate them," says Burton.
By structuring an organized response, deploying a systematic approach, creating targeted criteria, and use of an evaluation system, RRTs can save lives, he stresses.
Since implementation of this new team, CMH has experienced several RRT alerts, drills and real requests. Linda Earls and Cherie Whittington, both registered nurses for Medical/Telemetry Care, were the first staff members to alert the RRT in November.
"I think in the beginning, nurses were nervous to make the call but since the first call was made, we have had more to follow." says Burton. "We have encouraged the nurses to use this team when they notice subtle changes in their patient's status to prevent a code blue event. There is no such thing as a 'false call' when using the RRT."
There are clinical signs used as guidelines to call the RRT, but Burton feels the best one of all is the nurse's 'gut feeling.'
"Nurses have that sixth-sense of knowing something is just not right with their patient and calling the RRT is very appropriate in this instance," Burton says.
The RRT consists of a nurse from Intensive Care, a charge nurse and a respiratory therapist. When nurses activate the RRT, they have access to a team of excellent assessment responders that can provide a second opinion.
Physicians are always kept "in the loop" before and after a rapid response call. The RRT is not intended to take over a physician's patient. The intention is to help patients in a window of clinical instability when a patient's physician may not be present.
RRT translates into fast and accurate critical patient assessments around the clock and better patient outcomes such as fewer codes and lower mortality. RRTs were listed as the number one initiative to prevent avoidable deaths in the Institute for Healthcare Improvement's (IHI) 100,000 Lives Campaign. Although the campaign ended on June 14, 2006, the goal of saving lives continues.
"CMH is committed to providing safe and quality healthcare," says Burton. "We are hopeful that the successes of our Rapid Response Team will only add to the more than 100,000 lives that were saved during the IHI's campaign."
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