At Mishkind Kulwicki Law, with our many years of experience as healthcare advocates in Ohio, we are often the first ones to learn about dangers associated with new medical practices and technologies. By virtue of our role as injury lawyers, having a special interest in medical negligence cases, we get called when things go wrong. Recently, we have reviewed a number of cases where Rapid Response Teams (RRTs) have been involved. We are concerned enough about this development to report it here.
RRTs are typically made up of experienced nurses and other hospital personnel, such as residents or respiratory therapists, who are trained to respond to patients who are deteriorating in the hospital outside of an intensive care unit. Floor nurses can mobilize the RRT to assist in rapid evaluation of the patient and transfer to a higher level of care if needed. Sounds great, right?
In truth, it appears that RRTs were developed by hospitals to save money by understaffing floor nurses and relying on RRTs to save the day when a floor nurse becomes overwhelmed. The problem with this system is three-fold: (1) RRT nurses are pulled away from their assignments, usually in the ICU where they are continuously needed, to assist elsewhere in the hospital; (2) floor nurses are so woefully overburdened that patients are often well-neglected before the RRT is even alerted; and (3) rather than contacting the patient’s physician to report a change in condition, a traditional nursing function, floor nurses are being trained to alert RRTs instead. Rather than being an extra resource in the hospital, RRTs are being used to reduce monitoring by floor nurses and have become a sorry substitute for properly monitoring patients.
We are not alone in our observations. The largest nurses’ organization in the US agrees. National Nurses United recently published an article calling into question the effectiveness of RRTs. The article can be read here: http://nurses.3cdn.net/2f6c511fb66ed909b1_r1m6bak57.pdf.
The article points out that RRTs have become a crutch used by hospitals rather than putting patients in units where they are properly monitored in the first place. RRTs may seem like a good idea on paper, but in practice, they amount to another bait-and-switch by hospitals seeking to reduce costs at the expense of patient safety.