By Jamie Nicpon | Office of Communications & Marketing | 7-29-2019

A manuscript co-authored by College of Nursing Assistant Professor Jacinda Bunch, PhD, RN, along with Kimberly Dukes, PhD (co-first author) and Saket Girotra, MBBS, MS, MD (senior author) both from the Department of Internal Medicine at UI’s Carver College of Medicine, has been published by the Journal of the American Medical Association (JAMA) Internal Medicine.

The article, “Assessment of Rapid Response Teams at Top-Performing Hospitals for in-Hospital Cardiac Arrest”, has been initially published online by JAMA Internal Medicine.

Rapid response teams (RRTs) are synonymous with hospital medical emergency teams, which are highly specialized health care professionals that evaluate and treat patients who may experience sudden decline in their clinical condition.

In this study, the authors wanted to assess the differences in RRTs at top-performing hospitals versus non–top-performing hospitals based on survival of in-hospital cardiac arrest (IHCA). According to the article abstract, very little has been documented about RRTs and IHCA care across hospitals with varying levels of performance.

Drs. Bunch, Dukes, and Girotra found patterns that highlighted differences in the structure and function of RRTs at top-performing and non-top-performing hospitals. Top-performing hospitals in IHCA tended to have dedicated rapid response teams without other patient care responsibilities, allowing members to quickly respond to emergencies. RRT members seemed to create a partnership with bedside nurses before, during, and after rapid response calls, such as proactive rounding, inclusion in patient care, and debriefing.

“We also found that in top-performing hospitals, bedside nurses felt empowered by the organization to activate an RRT based on their clinical judgment and experience, without fear of criticism or blame,” noted Dr. Bunch.

This RRT study utilized data collected from Hospital Enhancement of Resuscitation Outcomes for In-hospital Cardiac Arrest (HEROIC), an ongoing mixed methods study of resuscitation practices at U.S. hospitals that is funded by the National Heart, Lung, and Blood Institute (PI: Brahmajee Nallamothu, University of Michigan and Paul Chan, Mid America Heart Institute). This process included interviews from nine hospitals; however, the team is planning additional research to include a wider range of hospitals, including those with fewer resources.

“Once validated, implementation of best practices broadly could potentially strengthen rapid response teams and improve patient safety,” added Dr. Bunch.  

Article: 

Dukes K, Bunch JL, Chan PS, et al. Assessment of Rapid Response Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest. JAMA Intern Med. 2019;179(10):1398–1405. doi:10.1001/jamainternmed.2019.2420

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