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program Survey results • From Nurses: – I felt that it was very helpful to have the RRT. I felt like the patient & family were satisfied also to see how quickly everyone responded. – They were great! Thanks! Thanks! Thanks! I was very apprehensive about this patient, and they really took the pressure away. – This is a helpful service. I had placed call to PMD prior to calling RRT. PMD on call did not call back until approx hour later, by then patient already settled in CC3 with appropriate care being delivered. Respiratory Survey • Respiratory Care – RRT Survey Results • Percentage of Respiratory Therapist who understand the RRT Concept – 80%. • Percentage of Respiratory Therapist who felt this was an important patient safety initiative – 92%. • Average response time to an RRT call, by the Respiratory Therapist – 95% responded within 1-5 minutes, 5% responded between 6-10 minutes. • Suggestions for Improvement • Conduct inservices for staff, giving criteria for when to call the Rapid Response Team. • Negative Experiences • How are RT’s to handle multiple STAT requests. • How are RT’s to handle multiple RRT calls, with insufficient staff to cover. • Too many staff in the patient room during the RRT calls. • Physician gave no direction, and left the patients room. 2006 SUMMARY OF RRT CALLS – NUMBER OF CALLS 159 – AVERAGE RESPONSE TIME/MINUTES 3.44 – AVERAGE LENGTH OF CALL/MINUTES 35.4 – PRIMARY MD NOTIFIED 89% – DISPOSITION OF PATIENT • TRANSFER TO HIGHER LEVEL OF CARE 69% • STAYED IN ROOM 31% COMPARISON OF CODES OUTSIDE OF CRITICAL CARE 2005 2006 • PCU 15 13 • 14% decrease in codes • MED/SURG 28 14 • 50% decrease in codes • TOTAL 43 27 • 38% TOTAL DECREASE IN CODES OUTSIDE OF CRITICAL CARE Codes Outside of Critical Care Inpatient Codes Outside of ICU Yearly Comparison 0 1 2 3 4 5 6 7 8 9 10 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2005 2006 Collaborative Calls Outside Critical Care Percent of Codes Outside the ICU 43.87% 50.00% 38.36% 42.42% 31.03% 55.17% 49.06% 43.75% 60.27% 41.67% 41.67% 44.12% 28.57% 100.00% 75.00% 20.00% 25.00% 0.00% 50.00% 28.57% 40.00% 50.00% 80.00% 33.33% 42.06% 48.89% 45.08% 47.52% 45.26% 45.08% 37.72% 52.08% 60.61% 56.60% 41.24% 44.44% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00% Baseline January February March April May June July August September October November December Month Percent Delmarva Collaborative WCH All Collaborative Average Collaborative Utilization of Team Utilization of the Rapid Response Team 8 28 27 30 28 26 23 28 30 31 37 40 0 6 9 17 12 7 18 13 14 16 18 16 11 21 19 21 17 18 18 22 21 23 30 33 10 0 5 10 15 20 25 30 35 40 45 Baseline January February March April May June July August September October November December Month Number of Calls Delmarva Collaborative WCH All Collaborative Average Challenges • Current staffing. • Consistent application of SBAR tool for reporting. • Consistent utilization of appropriate beds/units •Continue communication • • The deployment of a Rapid Response Team is one of the six initiatives. Health care experts say this has proven to be the most effective way of saving lives. • The six initiatives that save lives: Deploy Rapid Response Teams Deliver Reliable Evidence-Based Care for Acute Myocardial Infarction Prevent Adverse Drug Events Prevent Central Line Infections Prevent Ventilator-Associated Pneumonia Prevent Surgical Site Infections Joint Commission Goal 16A • Improve recognition and response to changes in a patient’s condition. • The organization selects a suitable method that enables health care staff members to directly request additional assistance from a specially trained individual(s) when the patient’s condition appears to be worsening. What is a Rapid Response Nurse? A Rapid Response Nurse (RRN) is a nurse who brings critical care expertise to the patients bedside (or where ever needed). Why Do We Need a Rapid Response Nurse? • People die unnecessarily every single day in our hospitals. We want to respond to a " SPARK" before it becomes a " FOREST FIRE“ • Our Goal is to RESCUE not RESUSCIATION • To help provide early interventions for