NCPA - National Center for Policy Analysis


December 8, 2004

Hospitals are adopting a new strategy -- modeled on the SWAT team concept -- that aims to cut mortality rates by eliminating red tape that causes delays in assisting critically ill patients, say observers.

The strategy involves Rapid Response Teams, which may include a critical-care nurse, intensive-care specialist and a respiratory therapist. The idea is for them to be mobilized by pager at the first sign of an impending crisis such as heart attack or stroke -- or any worrisome change in a patient's condition, from elevated blood pressure to a negative reaction to medication.

The teams are producing amazing results:

  • In a clinical trial of Australia's rapid response teams, adverse events have dropped by 50 percent, and post-operative hospital mortality rates have dropped by almost 37 percent at Melbourne's Austin and Repatriation Medical Centre.
  • At Missouri Baptist Medical Center in St. Louis, emergency respiratory calls have declined 60 percent since April; cardiac arrests declined 15 percent.
  • At Baptist Memorial Hospital in Tennessee, the rapid response team, created in April 2003, "code blues" have dropped by 28 percent and the hospital's risk-adjusted mortality rate has declined by 32 percent.

Two-thirds of hospital mortality rates are associated with "failure to rescue," according to HealthGrades, Inc., often due to a combination of factors. Hospital environments can be chaotic, staff must page the patient's doctor, which creates time delays, and nurses may not feel empowered to make decisions without the physician present. As a result, patients deteriorate rapidly while waiting for help to arrive.

However, rapid response teams are helping hospitals to eliminate red tape and respond quickly to patients in distress, say observers.

Source: Laura Landro, "Hospitals Form 'SWAT' Teams to Avert Deaths," Wall Street Journal, December 1, 2004.

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