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Pediatric Rapid Response Teams: Saving Lives One Child at a Time Karen B. Woronick RN, BSN ; Jesus Cepero RN, MSN, MPA, CNAA ; Heidi Dalton MD,FCCM; David C. Stockwell MD; Donna D. Johnson RN, BSN, MSN. LOGO. LOGO. LOGO. LOGO. Background. Phase II: Hospital-wide Activation.
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Pediatric Rapid Response Teams: Saving Lives One Child at a Time Karen B. Woronick RN, BSN ; Jesus Cepero RN, MSN, MPA, CNAA ; Heidi Dalton MD,FCCM; David C. Stockwell MD; Donna D. Johnson RN, BSN, MSN LOGO LOGO LOGO LOGO Background Phase II: Hospital-wide Activation • A pediatric rapid response team was developed as a result of increased patient acuity and code blue calls on acute care units. • The goal of a "Rapid Roll Out" was achieved by designing the program and initiating it within five weeks. • Preparation included development of team member roles, selection of pilot units and design of a data collection tool. • Education of faculty and staff included team roles, early detection of patient deterioration, and the activation process. • The goals for the team were to facilitate earlier assessment and potential intervention thereby decreasing the number of cardio-pulmonary arrests on acute care units. • We call our rapid response team the CAT ( Clinical Assessment and Triage) Team. • Implementation Lessons learned: • A multidisciplinary approach expedited the project • Education of all involved patient care providers and involved non-medical personnel is essential • Designing the program to accommodate decreased patient resources after 5pm is vital • Results: • Hospital-wide activation initiated July 3,2006 • Empowerment of nurses • Decreased Code Blue calls on acute care units by 51% • Mini root cause analysis forms initiated to assess causative factors of Code Blue calls • Data collection tool revised to capture specific information on patients recently transferred from Intensive Care Unit or Emergency Department Phase I : Pilot Early Results Phase III: Family Activation Design: • 5 week deadline for implementation • Define the Rapid Response Team and its multi-disciplinary team members • Designate Pilot Units: Highest Code Blue call rates & Diverse patient populations were chosen • Develop a documentation tool • Identify CAT Team members: ICU Physician, ICU Nurse and ICU Respiratory Therapist • Identify equipment required for a code activation-I-Stat • Set dates for pilot: April 3, 2006 thru June 30, 2006 • Build the CAT team structure • Activate the CAT Team: Physicians, Nurses, Techs or Respiratory Therapists may initiate. • Pilot results: • 10 Rapid Response Team calls during the pilot. • 40% of the patients had no change in level of care. • The total number of Code Blue calls on pilot units decreased by 75%. • Due to the dramatic decline of Code Blue calls the CAT Team was activated hospital-wide The overwhelming success of rapid response teams on patient outcomes in adult facilities challenged us to replicate the model in pediatrics. A two month pilot began April 3 and ended June 2, 2006. The three units with the highest code blue rates were selected for the pilot. The data collected demonstrated the utility of the program which has been expanded to include all patient units. Family activation of the CAT Team was initiated February 1, 2007. Phase II Phase I DATA COLLECTION TOOL • Projections: • Further prevention of Code Blue calls on acute care units • Expand the program to hospital based outpatient clinics • Expand and promote family activation of our CAT Team • Develop Cardiac CAT Team Bibliography: Iqbal, Yasmine (March 2006). Residents Finding Their Place on Rapid Response Teams. Retrieved January 20, 2007. from Http://www.acponline.org/journals/news/march06/residents.htm. Participation in National Benchmarking Studies improves Health Care, reduces Cost (January 20, 2006). Retrieved January 20, 2007, from Http://www.ucdmc.ucdavis.edu/update/2006_01_20/benchmark.htm. Pediatric Rapid Response Team At Yale Reduces Cardiorespiratory Arrests (October 27, 2006). Retrieved January 20,2007, from Http://www.medicalnewstoday.com/medicalnews.php?newsid=55197.