he use of rapid response teams may be masking hospitals’ underlying patient care inadequacies, says a Johns Hopkins patient safety expert in the Journal of the American Medical Association.
Rapid Response Teams are groups of clinicians assigned to provide rapid bedside care for patients who are in a critical condition.
“We need to think about why patients are deteriorating in the first place and do something rather than waiting until they fall off the cliff,” said author, Peter Pronovost, M.D., Ph.D., a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “There’s often this decline before patients crash. It’s typically not all of a sudden. Why doesn’t health care prevent the crash or pick it up earlier?”
The use of these rapid response teams is a sign that in terms of hospital care for recovering patients, some hospitals manage their beds in a way that has an impact on the patients, argue Pronovost and his coauthor, Eugene Litvak, Ph.D., president of the Institute for Healthcare Optimization.
The problem isn’t always that there aren’t enough beds for sick patients, though in some hospitals this problem does occur during certain times. Rather, they explain, the main problem is with the way hospitals manage the flow of patients.
For instance, many hospitals schedule all of their surgeries during the beginning of the day and week, overcrowding the Intensive Care Unit (ICU) during the middle of the day and middle of the week.
This overcrowding often leads hospital managers to move patients who still need intensive care out of the ICU in order to make way for even sicker patients. When patients are moved out of the ICU, they fail to receive the care they need, leading their conditions to deteriorate. Then the patient crashes.
At this point, the rapid response teams are called in.
Pronovost argues that hospitals must better manage these conditions so as to prevent patients from worsening so that they don’t need to appeal to the use of rapid response teams.
This can lead to an appearance that the rapid response teams are good at saving patients’ lives, however, they only look so good because the patients are allowed to get so bad in the first place.
“Imagine if we sent everyone from the ICU to the parking lot instead of to the floor,” Pronovost says. “The rapid response teams would look like they’re doing wonders because they would have to come in and save all of those patients. It’s not a rapid response team issue. It’s sending them to the proper level of care.”