Evidence suggests that delayed activation of rapid response teams (RRTs) is common and associated with adverse outcomes. However, research assessing factors associated with delayed activation is limited.
For an observational study published in the Journal of Critical Care, Peter M. Reardon, MD, and colleagues divided inpatients requiring RRT activation into two groups: those with activation within 1 hour of meeting call criteria and those with delayed activation (> 1 hour). Their goal was to uncover factors associated with delay that could serve as targets for future quality improvement interventions. Among 6,131 study participants, 26.0% experienced a delay. Reasons for RRT calls were significantly different between the groups, with respiratory distress (29.3% vs 24.8%), and hypotension (17.4% vs 13.2%) more common in the delayed activation group, and dysrhythmias (15.9% vs 18.5%) and altered level of consciousness (13.5% vs 18.7%) less common. Additionally, delayed activation was associated with increased mortality, ICU admission, and hospital length of stay (13 vs 15 days). “Patients experiencing delay were younger, more likely to have been admitted from home, and healthier at baseline,” says Dr. Reardon. “Delays were also more common on non-surgical wards.”
Dr. Reardon adds that RRTs are still relatively new as an intervention and he and his colleagues are learning more each year about how to use them effectively. The study team is analyzing other areas for improvement, such as RRT activation after-hours and recurrent RRT activation among certain patients.