News: AJCC Study Identifies Elements for Effective RRTs
Rapid Response Teams Require Teamwork, Communication
Effective RRT functioning demands a high level of nurse-physician collaboration, according to a study in American Journal of Critical Care
ALISO VIEJO, Calif. — May 1, 2013 — Clinical expertise is paramount to a rapid response team’s effectiveness, but strong teamwork and good communication among its multidisciplinary members are critical for optimal patient safety, according to a study in the May issue of American Journal of Critical Care (AJCC).
Rapid response teams (RRTs) — also called medical emergency teams — are mobile groups of clinicians with critical care expertise that respond quickly to a bedside nurse’s request for assistance with a patient whose condition might be worsening. The team typically includes a registered nurse, a respiratory therapist and a physician, who are each on call throughout their shift to respond within five minutes to RRT requests.
RRTs are a common patient safety initiative to reduce adverse events and prevent avoidable deaths among hospitalized patients, but research into how RRTs function as a team has been limited.
The study, titled “Rapid Response Teams: Qualitative Analysis of Their Effectiveness,” documents elements related to team effectiveness from multiple perspectives within RRTs. By exploring team structure, organizational culture, expertise, communication and teamwork, research findings indicate that teamwork and communication were essential elements of a successful team.
The study was led by nurse researchers Linda Searle Leach, RN, PhD, NEA-BC, CNL, assistant professor, School of Nursing, University of California, Los Angeles (UCLA), and Ann M. Mayo, RN, DNSc, professor, Hahn School of Nursing and Health Science, University of San Diego. They conducted in-depth interviews with individual RRT members and observed teams in action to collect data for their analysis.
“Individual highly skilled clinicians need to be able to quickly come together as a team to provide optimum care to the patient at a critical point in their care,” Leach said. “Team-based care delivery is not an optional approach in the quest to achieve safe and reliable care for every patient, every time — it is an imperative.”
The researchers found RRTs functioned well in managing patients at risk or in crisis, but the RRT structure poses unique teamwork and communication challenges. The day-to-day fluidity of team members limits opportunities to develop relationships or team skills. In addition, the clearly defined leadership role that nurses play within RRTs demands a level of collaboration among nurses and physicians that facilitates shared leadership in patient care, the study shows.
The study notes that the RRT training — like training for many other teams in healthcare settings — did not address interpersonal communication, collaboration and teamwork. Due to their structure, RRTs may need this type of training more than teams that work together regularly and under less time pressure, the study concludes.
Future training needs identified by study participants include a focus on communication; using simulation; and bringing individual nurses, physicians and respiratory therapists together to interact as a team in a non-urgent setting or simulated rapid response situations. Multidisciplinary training that focuses on communication, collaboration and a team orientation were recognized as necessary for effective RRT performance.
The study also notes the benefits of debriefing as a team immediately after an intervention, describing it as highly informative and useful for performance evaluation and team learning.
The study recommends healthcare leaders examine how RRT members work together as a team and recognize that teamwork strongly influences performance.
The research was sponsored by the Association of California Nurse Leaders and was funded by the Gordon and Betty Moore Foundation and the UCLA School of Nursing.
Access the study abstract and full-text PDF by visiting the AJCC website at http://www.ajcconline.org.
About the American Journal of Critical Care: The American Journal of Critical Care (AJCC), a bimonthly scientific journal published by the American Association of Critical-Care Nurses, provides up-to-date clinical research that focuses on evidence-based practice applications. Established in 1992, it includes clinical and research studies, case reports, editorials and commentaries. AJCC enjoys a circulation of 80,000 and can be accessed at www.ajcconline.org.
About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, Calif., the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN joins together the interests of more than 500,000 acute and critical care nurses and claims more than 235 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.
American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, Calif. 92656-4109;
Phone: (949) 362-2000; Fax: (949) 362-2020; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme