What are we looking to improve?
The Institute of Healthcare Improvement 100,000 Lives Campaign has identified as a national patient safety goal the institution of Rapid Response Systems to reduce preventable in-hospital deaths. According to published medical literature, 4% to 16% of hospitalized patients suffer an adverse event that eventually leads to cardiac arrest; 60% to 80% of these events are preceded by abnormal vital signs. Early detection can provide an opportunity to prevent further deterioration. Through this initiative, we look to reduce the incidence of preventable in-hospital deaths.
What strategies/measures have we implemented for improvement?
We have instituted a Rapid Response System that charges a multidisciplinary clinical team with performing prompt evaluation, triage and treatment of patients not in the Intensive Care Unit (ICU) who show signs of clinical deterioration. The system essentially brings ICU care in minutes to the bedside of any patient deemed to be at risk for deterioration; once stabilized, patients are transferred to the clinical area where they can receive the best and appropriate level of care. Our Rapid Response Teams (RRT) are headed by critical care physicians and are supported by medical residents, nurses, respiratory therapists and other ancillary staff. Family members can call for an RRT by dialing 77 on a hospital phone.
What have we accomplished to date?
The Rapid Response System's implementation at Mount Sinai Health System hospitals has led to opportunities for improvement in care, policy and staff and patient education. Beth Israel has responded to more than 1,500 rapid-response calls; Mount Sinai St. Luke's Roosevelt have since created guidelines for medicine house staff for the utilization of high concentration of oxygen and/or noninvasive ventilation; and Long Island College Hospital of Brooklyn has encouraged the participation of families and visitors by posting multilingual signs about the RRT activation process throughout public areas of the hospital.
What are our future plans?
We will continue to meet regularly to evaluate the system and develop ways to further improve it and educate everyone involved. Additionally, we are investigating the institution of a medical warning system to recognize patients at risk for deterioration earlier.