Collis Alexandra C, Raikhel A Vincent, Bell Joseph R, Carlbom David, Roach Victoria, Rosenman Elizabeth D
University of Washington, Seattle, WA, USA.
University of Washington Medical Center, Seattle, USA.
J Gen Intern Med. 2025 Jan;40(1):155-163. doi: 10.1007/s11606-024-08949-7. Epub 2024 Jul 22.
Rapid response teams (RRTs) are critical to the timely and appropriate management of acutely decompensating patients. In the academic setting, the vital role of RRT leader is often filled by a junior resident physician who may lack the necessary medical knowledge and experience. Cognitive aids help improve guideline adherence and may support resident performance as they transition into leadership roles.
This study evaluated the impact of a rapid response mobile application on intern performance during simulated rapid response events.
This randomized controlled trial compared the performance of interns in two simulated rapid response scenarios with and without access to the rapid response mobile application. The scenarios included anaphylaxis and supraventricular tachycardia (SVT). Simulations were video recorded and coded by trained raters.
Interns in all specialties at our institution.
Outcomes included (1) time to ordering critical medications (epinephrine and adenosine), (2) overall clinical performance using a checklist-based performance measure, and (3) usability of the mobile application. Enrollment and data collection occurred between November 2022 and February 2023.
Forty-four interns from 12 specialties were randomized to the intervention group (N = 22) and the control group (N = 22). Time to order critical medications was significantly reduced in the intervention group compared to control for anaphylaxis (P < 0.005) and SVT (P < 0.005). The intervention group had significantly higher performance scores compared to the control group for the anaphylaxis portion (P < 0.006). Usability scores for the rapid response toolkit were good.
Access to a rapid response mobile application improved the quality of care administered by interns during two simulated rapid response scenarios as determined by a decrease in time to ordering critical medications and improved performance scores. The intervention group found the mobile application to be usable. This work adds to existing literature supporting the use of technology-based cognitive aids to improve patient care.
快速反应团队（RRTs）对于急性失代偿患者的及时、恰当管理至关重要。在学术环境中，RRT领导者的重要角色通常由可能缺乏必要医学知识和经验的初级住院医师担任。认知辅助工具有助于提高对指南的依从性，并可能在住院医师过渡到领导角色时支持他们的表现。
本研究评估了快速反应移动应用程序在模拟快速反应事件期间对实习生表现的影响。
这项随机对照试验比较了实习生在两种模拟快速反应场景中的表现，一种可以使用快速反应移动应用程序，另一种不能使用。场景包括过敏反应和室上性心动过速（SVT）。模拟过程进行视频记录，并由训练有素的评分者进行编码。
我们机构所有专业的实习生。
结果包括（1）开具关键药物（肾上腺素和腺苷）的时间，（2）使用基于检查表的绩效指标评估的整体临床表现，以及（3）移动应用程序的可用性。招募和数据收集于2022年11月至2023年2月期间进行。
来自12个专业的44名实习生被随机分为干预组（N = 22）和对照组（N = 22）。与对照组相比，干预组在过敏反应（P < 0.005）和室上性心动过速（P < 0.005）情况下开具关键药物的时间显著缩短。在过敏反应部分，干预组的表现得分显著高于对照组（P < 0.006）。快速反应工具包的可用性评分良好。
通过缩短开具关键药物的时间和提高表现得分来确定，在两种模拟快速反应场景中，使用快速反应移动应用程序提高了实习生提供的护理质量。干预组认为移动应用程序可用。这项工作为支持使用基于技术的认知辅助工具改善患者护理的现有文献增添了内容。
