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Rapid Response Team Utilisation <24 Hours Post Emergency Admissions
By Ash Abeysekera
Presented by: Bronwyn Griffin
Princess Alexandra Hospital, UQ School of Medicine
Background
National Emergency Access Target (NEAT)
Do time improvements = quality improvements?
Background
What else……..?
Rapid Response Team (RRT)
Including Cardiac Arrest (CA)
Project Aims1. Compare ED LOS for
a. Patients requiring emergency activation
With
b. Patients admitted through the ED that did not
have an event
2. Describe Characteristics and outcomes of emergency activation
Methods
• Design: retrospective observational cohort study• Setting: PAH• Timeframe: June 1st – Nov 30th 2014• Databases 1. RRT and CA database (combined and separate) 2. EDIS3. HBCIS• Ethics
Results…
% of RRT activations within 24 hours of ED admission
Average ED LOS (minutes +/- 1SD)
393 433 439 233
NEAT compliance (%)All P=>0.05
Average Age (years +/- 1SD)
59 65 65 62
Results: Characteristics & Outcomes
SBP<90
33.93%
GCS22.02% SpO2<90
18.45%
Gender distribution (n%) P= 0.217
Results: After hours ED presentationP>0.05
Results: Triage categoryP=0.002
Results: Diagnosis
• Admission diagnosis on EDIS– I-J ICD 10 codes are cardio-respiratory diagnoses– 61 patients (19.14%) from early RRT/CAT from ED
admission group– 2994 patients (31.9%) from no RRT/CAT group– No significant differences in • Age• Gender• After hours presentation • ED LOS
Results: Mortality
Conclusion
• 1.79% of ED admissions have early RRT/CAT• ED LOS was longer in the RRT patient group• No evidence to suggest NEAT increases rate of
RRT
THANK YOU!
A big thank you to Ash
Dr Andrew StaibDr Rob Eley
Mr David MoorePA Clinical informatics
References1. Konrad, D., et al., Reducing in-hospital cardiac arrests and hospital mortality by introducing a medical emergency team.
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12(2): p. R46.3. Hillman, K., J. Chen, and D. Brown, A clinical model for Health Services Research-the Medical Emergency Team. J Crit Care,
2003. 18(3): p. 195-9.4. Winters, B.D., et al., Rapid-response systems as a patient safety strategy: a systematic review. Ann Intern Med, 2013. 158(5 Pt
2): p. 417-25.5. Lowthian, J.A., et al., Demand at the emergency department front door: 10-year trends in presentations. Med J Aust, 2012.
196: p. 128-32.6. COAG, National Partnership Agreement on Improving Public Hospital Services, C.o.F.F. Relations, Editor. 2010, Commonwealth
of Australia: Australia.7. Australian Institute of Health and Welfare, Australian Hospital Statistics National Emergency Access and Elective Surgery
Targets 2012. 2012, AIHW: Canberra.8. Considine, J., D. Charlesworth, and J. Currey, Characteristics and outcomes of patients requiring rapid response system
activation within hours of emergency admission. Crit Care Resusc, 2014. 16(3): p. 184-9.9. Lovett, P.B., et al., Rapid response team activations within 24 hours of admission from the emergency department: an
innovative approach for performance improvement. Acad Emerg Med, 2014. 21(6): p. 667-72.10. Committee, R., Code Blue - Medical Emergency, in Clinical, R. Commitee, Editor. 2014, Princess Alexandra Hospital, Metro
South Health: Australia.11. Medical Emergency Team End-of-Life Care investigators, The timing of rapid-response team activations: A multicentre
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Results: Characteristics & Outcomes
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