Department of Performance Management, Yale New Haven Health System, New Haven, Connecticut 06519, USA.
BMJ Qual Saf. 2012 May;21(5):391-8. doi: 10.1136/bmjqs-2011-000390. Epub 2012 Mar 2.
The objective of this study was to qualitatively describe the impact of a Rapid Response Team (RRT) at a 944-bed, university-affiliated hospital.
We analysed 49 open-ended interviews with administrators, primary team attending physicians, trainees, RRT attending hospitalists, staff nurses, nurses and respiratory technicians.
Themes elicited were categorised into the domains of (1) morale and teamwork, (2) education, (3) workload, (4) patient care, and (5) hospital administration. Positive implications beyond improved care for acutely ill patients were: increased morale and empowerment among nurses, real-time redistribution of workload for nurses (reducing neglect of non-acutely ill patients during emergencies), and immediate access to expert help. Negative implications were: increased tensions between nurses and physician teams, a burden on hospitalist RRT members, and reduced autonomy for trainees.
The RRT provides advantages that extend well beyond a reduction in rates of transfers to intensive care units or codes but are balanced by certain disadvantages. The potential impact from these multiple sources should be evaluated to understand the utility of any RRT programme.
本研究旨在定性描述一个拥有 944 张床位的大学附属医院快速反应团队（RRT）的影响。
我们对管理人员、主治医生、住院医师、主治护士、护士和呼吸技师共 49 名进行了开放式访谈。
所引出的主题被分为以下五个领域：（1）士气和团队合作；（2）教育；（3）工作量；（4）患者护理；（5）医院管理。除了提高急性病患者的护理质量外，还有一些积极影响：护士的士气和赋权得到提升，护士的工作量实时重新分配（减少紧急情况下对非急性病患者的忽视），并可立即获得专家帮助。负面影响包括：护士与医师团队之间的紧张关系加剧，主治医师 RRT 成员的负担加重，以及住院医师自主权的减少。
RRT 提供的优势不仅在于降低了转入重症监护病房或进行心肺复苏的比率，而且还平衡了某些劣势。应该评估这些多方面的影响，以了解任何 RRT 计划的效用。
