BMH Implements Rapid Response Team Initiative

Brattleboro Memorial Hospital adopted a strategy developed by the Institute for Healthcare Improvement (IHI) called “Rapid Response Team”. Studies show that the failure to recognize a patient’s deteriorating condition often leads to a variability in both quality of care and the safety of patients in health care today. This new initiative at BMH was originally piloted by a group of eight hospitals in 2002. They worked with the Institute for Healthcare Improvement to analyze inpatient mortality and to test the IHI hypothesis that a combination of evidence-based interventions can reduce mortality rates. This study led to the Rapid Response Team initiative.

The program reduces mortality and also the number of “Code Blue” (crash) calls, which are still used when there is a clear case of cardiopulmonary arrest (heart-stopping event).

Whereas the Code Blue team at BMH includes all levels of clinicians available who rush to the scene with a crash cart filled with all types of equipment for medical emergencies, the Rapid Response Team is composed of clinicians such as a respiratory care practitioner and a nursing supervisor – in collaboration with the physician – who bring critical expertise to the patient. This can include suctioning of an airway, additional oxygen, administration of intravenous fluids, drugs to relieve asthma-like symptoms, and/or short term use of a respirator. Getting help to patients before a Code Blue event increases their likelihood of survival.

Started in March, 2006, the Rapid Response Team has led to a significant improvement in patient care. As of December of that year, the Team was called to the bedside of 21 patients, 11 of whom were able to remain in their room and not have to be moved to the Special Care Unit. This past year, therefore, there were just four Code Blue events. During the same time period in the year earlier (when the Rapid Response Team was not yet available) there were nine Code Blue events. These numbers indicate that the Performance Improvement Initiative at BMH, endorsed by the IHI, has led to better patient outcome and better patient care.

An additional benefit from the initiative came about when members of the Rapid Response Team recognized that a select group of patients were experiencing the same symptoms following a particular procedure. The result was that a specialized team of physicians, nurses and therapists worked together to revise the patient care plan of these like patients, resulting in improved patients’ response to care.