Rapid Response Team

At some point in their careers, many experienced clinical employees have been dismayed to see a hospital patient who had been progressing suddenly begin to decline. According to research, however, subtle warning signs are usually present hours before a patient suffers a cardiac arrest, or Code Blue, requiring resuscitation.

“Over a year ago, the hospital put a Rapid Response Team in place housewide, and this has helped dramatically decrease the number of Code Blue incidents that have occurred,” explains Vicki Phelps, RN, BSN, clinical director of Critical Care.

The Rapid Response Team (RRT) is available 24/7 by paging 5100. When a Code Blue or Code Grey (the latter is used when a visitor suddenly becomes ill) is issued, or a patient noticeably starts to decline, the RRT is available to respond. The team works with all areas of the hospital, with the exception of Critical Care/Telemetry and the Emergency Department, because the nursing staff in these areas is already equipped with similar specialized training.

The RRT initial responders consist of a critical care (Central Telemetry) nurse and a respiratory therapist, who will travel to the patient’s bedside as soon as they’re paged. The secondary response team includes hospitalists, attending physicians, and pharmacists, as needed.

“The patient’s own physician will also be called,” says Vicki, “But the two member Rapid Response Team will immediately assess the patient, consult with the patient’s bedside caregiver, and take appropriate action to begin helping the nurses while they are calling the physician to get some orders.”

Some examples of what the RRT might do include: monitoring the patient’s pulse or oxygen levels; ordering an EKG; or getting a CT scan done promptly if the patient shows any signs of stroke so that – if it is indicated– tPA (clot-busting drugs) can be administered within the three-hour window.

“The Rapid Response Team functions as a nurse consult that augments the care the nurses on that floor are giving to the patient,” explains Vicki. “The RRT does not try to replace that care.”

Whether it is a nurse on the patient’s unit who notices a decline and pages the Rapid Response Team, or someone visiting the patient asks the nurse to make the call, the goal is to get the patient stabilized quickly and avert a code.

“We always prefer to be called before there is a Code Blue,” Vickie emphasizes. “The goal is to mobilize the RRT much sooner – at the first sign that the patient’s condition is declining. While many signs are likely to be noticed by nurses, some of the earliest signs of a declining patient are more likely to be spotted by visiting family members – the people who know that patient best. That’s why it’s part of the National Patient Safety Goals that we educate patients and family members about the existence of a Rapid Response Team and when to request paging them.”