A Patient Safety Solution: Evaluation of a 24/7 Nurse-led Proactive Rapid Response Program

Background: Rapid Response Systems are patient safety programs that have been implemented around the world to reduce preventable patient harm and failure to rescue. Problem: There was a high rate of cardiac arrests outside the intensive care unit and absence of a structured system to identify and rescue patients with signs of clinical deterioration prior to cardiac arrest. Objectives: To evaluate the impact of a structured 24/7 nurse-led proactive rapid response program on clinical deterioration and cardio-pulmonary arrests. Methods: This study took place in a 650-bed quaternary academic regional referral center. The study period was between January 2014 and February 2020. A rapid response system redesign was initiated in early 2017 and a 24/7 nurse-led proactive rapid response program launched in December 2017. Results: A statistically significant decrease in rates of critical care cardio-pulmonary arrests, non-critical care cardio-pulmonary arrests, rapid response consults, unplanned ICU transfers, and hospital deaths occurred following implementation of the 24/7 nurse-led proactive rapid response program. Conclusions: Implementation of a structured 24/7 nurse-led rapid response program can decrease cardio-pulmonary arrests, unplanned transfers to ICU, and hospital deaths.