MISSING THE YELLOW FLAGS: DOES A TARDY RESPONSE TRIGGER THE RAPID RESPONSE?

Erika Leung, MD*;Omar Al-Abboud, MD;Shuang Song, MD, PhD;Shahed Shams, MD;Keerthi Patlolla, MD;Osman Qaiyum, MD;Sara Hawatmeh, MD;John English, MD;Fred Balis, MD and Hameem Kawsar, MD, PhD, St Luke's Hospital, Chesterfield, MO

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

Abstract number: 86

Categories: Outcomes Research, Research Abstracts

Keywords:

Background: A Rapid Response (RR) Team is activated when there is an acute change in a patient’s condition. Rapid responses are called when certain criteria are met. A delay in activation of the rapid response or non-activation of the rapid response can be associated with increased morbidity and mortality. Goal 16 of the Joint Commission’s 2009 National Patient Safety Goals is to improve the identification of and response to clinical deterioration in hospital-ward patients. We conducted a study to elucidate the common causes of RR, the timing and pattern of RR, the outcomes of RR, and if any of those RR events could have been prevented.

Methods: We retrospectively reviewed electronic medical records of all the RR events that occurred between July and December 2015 at St. Luke’s Hospital. We examined the changes in clinical conditions, vital signs, and laboratory and imaging study results of 24 hours preceding the onset of RR event. We used clinical criteria to identify if any of these RR events were potentially preventable. 

Results: A total of 139 RR events occurred during the study period. The most common cause for a RR was altered mental status. Forty-three (31%) of these RR occurred within 24 hours of arrival from the ED. Thirty-six (26%) RR events occurred between 7 and 11 am and 40 (29%) occurred between 3 and 7 pm, coinciding with the shift changes of the health care professionals. Thirty-four (24%) RR events were considered potentially preventable, and were frequently related to unaddressed abnormal vital signs and in-hospital narcotic use.

Conclusions: Our study reveals that 1 in 4 RR events are potentially preventable. RR were also correlated with shift changes and tended to occur within 24 hours after admission from the ER. These findings will help us to identify and act on early warning signs in a timely fashion which will lead to resource conservation, and reduce patient morbidity and mortality.

To cite this abstract:

Leung, E; Al-Abboud, O; Song, S; Shams, S; Patlolla, K; Qaiyum, O; Hawatmeh, S; English, J; Balis, F; Kawsar, H . MISSING THE YELLOW FLAGS: DOES A TARDY RESPONSE TRIGGER THE RAPID RESPONSE?. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 86. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/missing-the-yellow-flags-does-a-tardy-response-trigger-the-rapid-response/. Accessed July 20, 2019.

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