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Ensuring Rapid Response Team Care Aligns With Patients' Limitations of Medical Therapy: A Quality Improvement Project.

BACKGROUND
Rapid response teams (RRTs) are designed to improve patient care during deterioration in clinical condition.


LOCAL PROBLEM
Patients' desired limitations of medical therapy (LOMTs) were not documented or communicated to the RRT, and patients received care not aligned with their wishes.


METHODS
A multidisciplinary team developed a process for improving documentation, communication of LOMTs, and care delivery on 3 medical cardiology units. The team implemented 3 Plan-Do-Study-Act (PDSA) cycles over 6 months.


INTERVENTIONS
In cycle 1, team members taught the unit nurses, RRT members, and physicians to share LOMTs during handoff communications. Cycle 2 engaged case managers in LOMT documentation. In cycle 3, unit-based RRT simulation was conducted.


RESULTS
All care delivered by the RRT aligned with the documented LOMTs. Documentation of LOMTs increased from 76% to 82.5% (P = .014).


CONCLUSIONS
Education, scripting, and simulation were successful strategies to ensure that care given during RRT events aligned with patients' wishes.