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Impact of proactive rounding by a rapid response team on patient outcomes at an academic medical center.

BACKGROUND
The impact of rapid response teams (RRT) on patient outcomes remains uncertain.


OBJECTIVE
To examine the effect of proactive rounding by an RRT on outcomes of hospitalized adults discharged from intensive care.


DESIGN
Retrospective, observational study.


SETTING
Academic medical center.


PATIENTS
All adult patients discharged alive from the intensive care unit (ICU) at the University of California San Francisco Medical Center between January 2006 and June 2009.


INTERVENTION
Introduction of proactive rounding by an RRT.


MEASUREMENTS
Outcomes included the ICU readmission rate, ICU average length of stay (LOS), and in-hospital mortality of patients discharged from the ICU. Data were obtained from administrative billing databases and analyzed using an interrupted time series (ITS) model.


RESULTS
We analyzed 17 months of preintervention data and 25 months of postintervention data. Introduction of proactive rounding by the RRT did not change the ICU readmission rate (6.7% before vs 7.3% after; P = 0.24), the ICU LOS (5.1 days vs 4.9 days; P = 0.24), or the in-hospital mortality of patients discharged from the ICU (6.0% vs 5.5%; P = 0.24). ITS models testing the impact of proactive rounding on secular trends found no improvement in any of the 3 clinical outcomes relative to their preintervention trends.


CONCLUSIONS
Proactive rounding by an RRT did not improve patient outcomes, raising further questions about RRT benefits.