Elsevier

The Journal of Pediatrics

Volume 163, Issue 6, December 2013, Pages 1772-1774
The Journal of Pediatrics

Clinical and Laboratory Observations
Variability in the Implementation of Rapid Response Teams at Academic American Pediatric Hospitals

https://doi.org/10.1016/j.jpeds.2013.07.018Get rights and content

Pediatric rapid response teams have become standard over the past decade, but are organized heterogeneously at US academic hospitals, with rare financial support. To compare rapid response team efficacy, pediatric hospitals should agree on standard outcome measures, whether it be a standard definition of floor arrest or of clinical deterioration.

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Methods

We selected 34 academic US pediatric hospitals, identified using top US News and World Report rankings, for participation in a 62-question, Institutional Review Board–approved telephone survey. Respondents were typically Arrest Committee chairpersons or pediatric ICU (PICU) medical directors.

Results

Thirty of the 34 hospitals were successfully contacted by a single investigator between March and May 2012 (response rate, 88%). All of the participating institutions provided extracorporeal membrane oxygenation, a PICU fellowship program, and a minimum of 1 PICU physician in the hospital overnight, with 43% providing 24-hour in-house PICU attending coverage.

All 30 responding hospitals reported maintaining 24 hour/day–7 day/week arrest teams and RRTs (Tables I and II). Roughly one-quarter (23%)

Discussion

Formal RRTs have become standard at pediatric hospitals, consistent with the Joint Commission's National Patient Safety Goals of 2008 directing hospitals to “improve recognition and response to changes in a patient's condition.”7 Although children's hospitals have rapidly formed RRT programs, only 23% of our responding hospitals, 4 years after the 2008 Patient Safety Goals, reported receiving any financial RRT support, with several commenting that the PICU was understaffed during RRT calls.

RRTs

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The authors declare no conflicts of interest.

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