Purpose: The purposes of this study were to: a) describe the factors that influence healthcare organizations’ choice of Rapid Response Team (RRT) structure and function; and b) describe how organizations evaluate RRT’s impact, effectiveness, and costs.
Background: Hospitals use RRTs to address acute patient deterioration. There are a variety of RRT structures and functions, but it is unclear how hospitals determine what is best for their organization. Although studies examine the impact of RRTs on various patient outcomes, little is known about outcomes hospitals are measuring, what they value in use of a RRT, and about costs and economic implications related to a RRT.
Methods: This study used an ethnographic, descriptive qualitative design along with purposive and snowball sampling to recruit nurse executives and key informants in moderate-sized hospitals with a mature RRT. Following completion of a demographic questionnaire, an in-person interview was conducted. Audio-recorded interviews were transcribed verbatim, checked for accuracy, and entered into Ethnograph, a qualitative data management program. Data were analyzed using content analysis and constant comparison. Demographic data were analyzed using descriptive statistics.
Results: The sample was comprised of 27 participants from 15 hospitals in five states including 13 non-profit. Themes emerging from the data included value of the RRT and monitoring of the RRT. Participants valued a variety of patient, healthcare team, and organizational outcomes. Participants described both formal and informal evaluation of RRT outcomes. In most hospitals, a critical care charge nurse responded to all RRT calls, with some hospitals utilizing a designated rapid response nurse with chief RRT duties to respond to calls. Participants described phases in RRT development that included external and internal influencers, decision processes about RRT structure and function and cost considerations.
Conclusion: Understanding what organizations value in use of a RRT and determining optimal outcome measurements to evaluate their effectiveness is an important step in helping them meet their patient safety objectives. Understanding the costs and benefits associated with use of a RRT can help organizations as they seek economic equilibrium in patient well-being and costs.
|Advisor:||McSweeney, Jean C.|
|Commitee:||Barone, Claudia P., Jones, Tammy K., Tilford, Mick, Wright, Patricia B.|
|School:||University of Arkansas for Medical Sciences|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 77/11(E), Dissertation Abstracts International|
|Keywords:||Failure to rescue, Impact and effectiveness, Rapid response team, Structure and function|
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