Rethinking How Hospitals React When a Patient's Health Deteriorates

by Tanya Thomas on  September 23, 2010 at 10:12 AM Hospital News
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The growing use of rapid response teams dispatched by hospitals to evaluate patients whose conditions have suddenly deteriorated may be masking systemic problems in how hospitals care for their sickest patients, says a prominent Johns Hopkins patient safety expert.

In a commentary published in the Sept. 22 issue of the Journal of the American Medical Association, Peter Pronovost, M.D., Ph.D., a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, and co-author Eugene Litvak, Ph.D., president of the Institute for Healthcare Optimization, argue that the proliferation of these rapid response teams is just a quick fix to save patients who crash once they are moved out of intensive-care units. Instead, the authors argue, hospitals need to figure out why these patients aren''t receiving adequate care and better manage beds to ensure patients are getting what they need whether inside or out of the ICU.

"We need to think about why patients are deteriorating in the first place and do something rather than waiting until they fall off the cliff," says Pronovost, who is also medical director for Johns Hopkins'' Center for Innovation in Quality Patient Care. "There''s often this decline before patients crash. It''s typically not all of a sudden. Why doesn''t healthcare prevent the crash or pick it up earlier?"

At the same time, he says, research on whether rapid response teams (RRTs) are effective is equivocal at best.

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