The Rapid Response System Team: Building and Maintaining

Rapid response teams (RRTs) provide a mechanism for recognizing the deteriorating hospitalized patient, provide timely care, and save lives. The structure of such teams varies according to healthcare settings but generally includes an intensive care doctor and nurse and may include respiratory therapists, ward-based doctors, and emergency physicians, among other personnel. The core skills of an effective RRT are to diagnose and treat critical illness, provide resuscitation, facilitate disposition, and communicate effectively to ward, hospital, and intensive care staff. The governance structure required to support an RRT must contain several key elements, including administrative leadership, quality improvement and safety initiatives, data analytics, and outreach education. Hospital administrative leadership is vital to help promote a culture of safety and ensure that regulatory standards are met by taking responsibility for resourcing RRTs, supporting quality improvement initiatives, and responding to relevant performance metrics. An RRT requires specialized equipment to support oxygenation and ventilation, venous access, and also readily accessible resuscitation medications. The exact equipment and medication stocks must be tailored according to the specific context of individual healthcare settings. Education and outreach can be mediated by the RRT to ensure that hospital staff know how to recognize clinical deterioration and are familiar with calling criteria. The RRT can provide follow-up of children who remain on the ward following an RRT activation to support ward staff, ensure that treatment plans are enacted, and verify that the patient disposition remains appropriate. An effective rapid response system is tasked with improving the safety of hospitalized children. This chapter outlines the core elements that are required to build and maintain a rapid response team as part of this system.