Clinical and Laboratory ObservationsVariability in the Implementation of Rapid Response Teams at Academic American Pediatric Hospitals
Section snippets
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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Cardiopulmonary Resuscitation
2019, A Practice of Anesthesia for Infants and ChildrenCardiopulmonary Resuscitation
2018, A Practice of Anesthesia for Infants and ChildrenRothman Index variability predicts clinical deterioration and rapid response activation
2018, American Journal of SurgeryCitation Excerpt :Despite significant attention to outcome following RRT activation, its effect on reducing patient cardiac arrest and unexpected patient mortality is mixed.1–5 Although there has been near universal adoption of RRT, criteria for activation are not well defined, and there is significant site-to-site practice variation in both pediatric and adult hospitals.6,7 In order to aid the identification of general ward patients experiencing physiologic decline, several early warning scores have been developed.8–12
The authors declare no conflicts of interest.