2.50
Hdl Handle:
http://hdl.handle.net/10755/157778
Type:
Presentation
Title:
How Rapid Response Teams Perform as a Team
Abstract:
How Rapid Response Teams Perform as a Team
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Leach, Linda Searle, PhD, RN, NEA-BC
P.I. Institution Name:University of California Los Angeles, UCLA School of Nursing
Title:Assistant Professor
Contact Address:700 Tiverton Factor Bldg 3-234, Los Angeles, CA, 90095-6917, USA
Contact Telephone:626-437-7697
Co-Authors:Ann Mayo, DNSc, RN, Professor
Purpose: The purpose of this qualitative study is to explore and describe the factors perceived to contribute to team performance of a Rapid Response Team (RRT) from the perspective of the RRT members and those involved in the design, implementation, and evaluation of the RRT at a large, teaching hospital that has a two year history with this safety intervention and has demonstrated an evolution in their process of identifying patients at risk for clinical instability and successfully rescuing these patients. Background:  Safe healthcare service delivery systems prevent avoidable deaths. Specifically, research reveals that signs and symptoms of clinical deterioration and impending code arrest are present six to eight hours prior (Franklin and Matthew, 1994; Hillman et al., 2001). This evidence has brought to light that code arrests are preventable and patient's symptoms and clinical status should be managed to prevent this adverse event. Not to do so constitutes an error. One care process/safety intervention designed specifically to identify and manage patients who are at risk, clinically unstable or deteriorating is the rapid response team (RRT). A RRT is a responding team designed to address a patient crisis and mediate a mismatch between available unit-level resources and the immediate needs of unstable hospitalized patients (DeVita et al., 2006). Teams are the critical component of any rapid response system. The IOM identifies the development of effective teams as a redesign imperative and views high performing patient-centered teams as a fundamental component of the care system for the 21st century (IOM, 2001). Yet, the focus of most of the literature on RRTs has been only on the outcomes of this safety intervention through reporting of mortality rates, frequency of non-ICU code arrests and unplanned admissions to the ICU. A description of how a RRT responds and performs as a team is needed. Methods: This qualitative study using grounded theory methodology has been carried out in a large, public, teaching hospital in the northern California bay area. Observation and semi-structured interview methods were used to identify the factors that contribute to performance of the RRT. Nine observations were conducted of RRTs responding to calls from eight in-patient units and one ambulatory clinic on various days including Saturday and Sunday. Data from field notes will be used to inform analysis of the narrative data. Narrative data regarding team structure, communication processes and team effectiveness was collected in private, semi-structured interviews. Theoretical sampling was used to select 23 key informants. Interviews were digitally audio-recorded and transcribed verbatim. Qualitative content analysis including coding, comparing, contrasting, and categorizing data will be carried out using a grounded theory approach for data analysis. Results: Data analysis will be completed by February 2009. Findings will be presented. Implications: Findings from this study have implications for identifying the unique and challenging structure employed by RRTs, as often, the team members responding are different each time. Such loosely coupled teams have little opportunity to develop team skills. Teams such as these, even when they function expertly to respond to patient needs, may have a greater need for team work training than teams that work together regularly and who are under less time pressure to perform.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHow Rapid Response Teams Perform as a Teamen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157778-
dc.description.abstract<table><tr><td colspan="2" class="item-title">How Rapid Response Teams Perform as a Team</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Leach, Linda Searle, PhD, RN, NEA-BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California Los Angeles, UCLA School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">700 Tiverton Factor Bldg 3-234, Los Angeles, CA, 90095-6917, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">626-437-7697</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lleach@sonnet.ucla.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Ann Mayo, DNSc, RN, Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this qualitative study is to explore and describe the factors perceived to contribute to team performance of a Rapid Response Team (RRT) from the perspective of the RRT members and those involved in the design, implementation, and evaluation of the RRT at a large, teaching hospital that has a two year history with this safety intervention and has demonstrated an evolution in their process of identifying patients at risk for clinical instability and successfully rescuing these patients. Background: &nbsp;Safe healthcare service delivery systems prevent avoidable deaths. Specifically, research reveals that signs and symptoms of clinical deterioration and impending code arrest are present six to eight hours prior (Franklin and Matthew, 1994; Hillman et al., 2001). This evidence has brought to light that code arrests are preventable and patient's symptoms and clinical status should be managed to prevent this adverse event. Not to do so constitutes an error. One care process/safety intervention designed specifically to identify and manage patients who are at risk, clinically unstable or deteriorating is the rapid response team (RRT). A RRT is a responding team designed to address a patient crisis and mediate a mismatch between available unit-level resources and the immediate needs of unstable hospitalized patients (DeVita et al., 2006). Teams are the critical component of any rapid response system. The IOM identifies the development of effective teams as a redesign imperative and views high performing patient-centered teams as a fundamental component of the care system for the 21st century (IOM, 2001). Yet, the focus of most of the literature on RRTs has been only on the outcomes of this safety intervention through reporting of mortality rates, frequency of non-ICU code arrests and unplanned admissions to the ICU. A description of how a RRT responds and performs as a team is needed. Methods: This qualitative study using grounded theory methodology has been carried out in a large, public, teaching hospital in the northern California bay area. Observation and semi-structured interview methods were used to identify the factors that contribute to performance of the RRT. Nine observations were conducted of RRTs responding to calls from eight in-patient units and one ambulatory clinic on various days including Saturday and Sunday. Data from field notes will be used to inform analysis of the narrative data. Narrative data regarding team structure, communication processes and team effectiveness was collected in private, semi-structured interviews. Theoretical sampling was used to select 23 key informants. Interviews were digitally audio-recorded and transcribed verbatim. Qualitative content analysis including coding, comparing, contrasting, and categorizing data will be carried out using a grounded theory approach for data analysis. Results: Data analysis will be completed by February 2009. Findings will be presented. Implications: Findings from this study have implications for identifying the unique and challenging structure employed by RRTs, as often, the team members responding are different each time. Such loosely coupled teams have little opportunity to develop team skills. Teams such as these, even when they function expertly to respond to patient needs, may have a greater need for team work training than teams that work together regularly and who are under less time pressure to perform.</td></tr></table>en_GB
dc.date.available2011-10-26T20:11:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:11:43Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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