Kinan Kassar, MD*;Dorothy Pusateri and Anastasios Kapetanos, MD, Allegheny General Hospital, Pittsburgh, PA

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 175

Categories: Quality Improvement, Research Abstracts

Although controversy exists regarding the effectiveness of rapid response teams (RRTs), they are an essential tool in most hospitals to address rapid patient deterioration and ideally optimize patient safety (1-5).
The utility of RRTs is dependent on the quality of the response, which in turn depends on multiple individual and institutional factors. Communication gaps and lack of collaboration among team members in emergency settings can negatively affect decision making and patient safety (6-7). The unfamiliarity of respondents with the patient’s condition, and the redundancies caused by the staggered arrival of different respondents to the patient’s location, may result in perceptible detriments in team performance. A potential way to circumvent these barriers is to provide the patient’s admission diagnosis and the reason for rapid response (RR) activation via pager, at the time of activating the RRT.

The RR system at our institution can be activated by calling the hospital’s operator office, which sends a message to the pagers carried by the providers assigned to the RRT for that specific day.
For the purpose of this study, operators were asked to inquire about the reason for calling the RR and the patient’s admission diagnosis every time a staff member called to activate the system. The information was then included in the paging message sent to the RRT members. The telephone office algorithm also allowed callers to activate the RRT without delay if they couldn’t provide this information.
A scored questionnaire was developed to measure the impact of the intervention on residents’ experiences(table 1). The survey consisted of 5 questions and the answers were listed from the most negative to the most positive with an incremental increase in the assigned score.  A resident experience score was calculated before and after two-month intervention period. A post-survey to Hospitalists about their experience with the intervention was also conducted.

During the study period, 22 PGY-2 and PGY-3 medicine residents carried the RR pager. The RR system was activated 96 times on 93 patients admitted to the hospital. The reason for activating the RRT was mentioned in 67/96(70%) of paging messages and the admission diagnosis in 30/96(31%).  Fifty-eight percent of the surveyed residents responded to two or more rapid responses during the study period. The total resident experience score was 57% before and after the intervention. Half of the surveyed residents admitted that their initial unfamiliarity with the patient’s condition affected their decision making at least (Frequently) during a rapid response compared to 33% after the intervention. Communication among RRT members was rated as (Effective) by 33% of surveyed residents after the intervention compared to 11% before the intervention. Twelve Hospitalists responded to a survey about their experience with the intervention. The majority of them (70%) didn’t notice a significant change in their decision making after the implementation of the intervention. The study may be limited by the insufficient exposure of respondents to the intervention as 40% of residents and 60% of the hospitalists were involved in 0-1 RR during the study period. Additionally, the reason for RR and the patient’s admission diagnosis were mentioned only in 2/3 and 1/3 of messages, respectively.

Providing preliminary information about the rapid response to RRT members at the time of activating the system doesn’t have a significant effect on the respondents experience.

To cite this abstract:

Kassar, K; Pusateri, D; Kapetanos, A . DETAILED RAPID RESPONSE PAGER MESSAGES DO NOT IMPROVE RESPONDENTS PERCEPTION OF TEAM PERFORMANCE. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 175. Journal of Hospital Medicine. 2017; 12 (suppl 2). Accessed May 24, 2019.

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