Rapid response team moves into action at WRMC
(Fayetteville, AR) It was 3:00 a.m. when a male patient recovering from abdominal surgery awoke with a sudden onset of chest pain. He quickly pushed the call button and his nurse hurried in. She confirmed that the patient did, indeed, have chest pain, but was the pain radiating from his surgical site indicating a possible problem there, or was it something totally unrelated to the surgery? Was it his heart? Without hesitation, his nurse picked up the bedside phone and dialed for help from Washington Regional’s new Rapid Response Team.
The first and only team of its kind in Northwest Arkansas, Washington Regional’s T-REX (Team Response to Extremes) rapid response team is all about identifying potential patient problemsbefore they become problems, then bringing in the most experienced members from key areas of patient care, (emergency services, respiratory therapy, and critical care nursing), to intervene to keep patients from going into cardiac arrest.
Arriving at the patient’s bedside in just minutes, the team completed an assessment and an immediate work-up on the patient’s heart was ordered. The tests came back positive for heart trouble and the patient’s physician was notified right away. A heart specialist was called to examine the patient and treatment was ordered, successfully averting what could have been a life-threatening situation.
Pioneered in Australia, rapid response teams (RRTs) are estimated to be in place in about 100 U.S. hospitals. Hospitals using rapid response teams typically report significant reductions in the number of cardiac arrests, unplanned transfers to the ICU, and, in some cases, the death of patients. .
A Rapid Response Team is like a Code Blue Team, but well, more extreme. A Code Blue Team responds when a patient is experiencing a cardiac arrest. The Rapid Response Team responds whenever any patient caregiver determines that the patient is showing signs that indicate a potential cardiac arrest. Since implementing the program on October 30, the Rapid Response Team at Washington Regional has responded to an average of two calls per day.
"We’ve empowered our nurses and others to call the Rapid Response Team for whatever level of help they need," says Dr. David Ratcliff, Chief of Medical Affairs. "Our nurses are on the front line of patient care and they can spot a potential problem long before anyone else is aware of its existence. Once they’ve identified a potential problem the Rapid Response Team is their immediate resource for assistance."
The Rapid Response Team does not replace the patient’s doctor, nor does it take over for the nurse. Instead, the Team works side-by-side with the patient’s nurse. "We deliberately included ICU nurses as part of the Rapid Response Team—ICU nurses typically are the most experienced and tenured nurses," says Chief Nursing Officer, Claudia Williams. "They can be enormously helpful to the other nurses,."
"As soon as we heard about the concept of a rapid response team, we knew it was something that we wanted for our patients," says Dr. Ratcliff. "We began immediately to learn more so we could bring this level of patient care to Washington Regional." Ratcliff recruited planning committee members from emergency services, respiratory therapy, and critical care nursing. "They loved the idea right away," he says.
As with any new program, the rapid response planning committee was concerned about adding "one more thing" to the nurses’ already full plates. They purposely chose to call the new rapid response team T-REX, so it would be memorable and personable. Signs, posters, and phone stickers on the units remind nurses to "Call T-REX at 3333" if they need help.
"We were a little worried about how well this new team would be accepted," says Dr. Ratcliff. "But we needn’t have worried: the concept sold itself. We completed the training for staff, and on the first morning T-REX went live, the team got four calls before noon."
"We believe the presence of the RRT will help with nursing recruitment and retention. Nurses like knowing there is always someone to call," adds Williams.
The team is collecting clinical data about outcomes to gauge the impact of the RRT, including number of calls and outcomes. T-REX, here for patients at WRMC!