PDF(Pubmed)
Abstract：
BACKGROUND: Rapid response team (RRT) and code activation events occur relatively commonly in inpatient settings. RRT systems have been the subject of a significant amount of analysis, although this has been largely focused on the impact of RRT system implementation and RRT events on patient outcomes. There is reason to believe that the structured assessment of RRT and code events may be an effective way to identify opportunities for system improvement, although no standardised approach to event analysis is widely accepted. We developed and refined a protocolised system of RRT and code event review, focused on sustainable, timely and high value event analysis meant to inform ongoing improvement activities.
METHODS: A group of clinicians with expertise in process and quality improvement created a protocolised analytic plan for rapid response event review, piloted and then iteratively optimised a systematic process which was applied to all subsequent cases to be reviewed.
RESULTS: Hospitalist reviewers were recruited and trained in a methodical approach. Each reviewer performed a chart review to summarise RRT events, and collect specific variables for each case (coding). Coding was then reviewed for concordance, at monthly interdisciplinary group meetings and \'Action Items\' were identified and considered for implementation. In any 12-month period starting in 2021, approximately 12-15 distinct cases per month were reviewed and coded, offering ample opportunities to identify trends and patterns.
CONCLUSIONS: We have developed an innovative process for ongoing review of RRT-Code events. The review process is easy to implement and has allowed for the timely identification of high value improvement opportunities.
METHODS: A group of clinicians with expertise in process and quality improvement created a protocolised analytic plan for rapid response event review, piloted and then iteratively optimised a systematic process which was applied to all subsequent cases to be reviewed.
RESULTS: Hospitalist reviewers were recruited and trained in a methodical approach. Each reviewer performed a chart review to summarise RRT events, and collect specific variables for each case (coding). Coding was then reviewed for concordance, at monthly interdisciplinary group meetings and \'Action Items\' were identified and considered for implementation. In any 12-month period starting in 2021, approximately 12-15 distinct cases per month were reviewed and coded, offering ample opportunities to identify trends and patterns.
CONCLUSIONS: We have developed an innovative process for ongoing review of RRT-Code events. The review process is easy to implement and has allowed for the timely identification of high value improvement opportunities.
摘要：
背景：快速反应小组（RRT）和代码激活事件在住院设置中相对常见。RRT系统已经成为大量分析的主题，尽管主要关注RRT系统实施和RRT事件对患者结局的影响.有理由相信RRT和代码事件的结构化评估可能是识别系统改进机会的有效方法，尽管没有标准化的事件分析方法被广泛接受。我们开发并完善了RRT和代码事件审查的协议系统，专注于可持续发展，及时和高价值的事件分析意味着通知正在进行的改进活动。
方法：一组在流程和质量改进方面具有专业知识的临床医生为快速响应事件审查制定了一个规范的分析计划，试点，然后迭代优化一个系统的过程，应用于所有后续案例进行审查。
结果：以有条理的方法招募和培训医院评审员。每个审阅者都进行了图表审阅以总结RRT事件，并为每个案例收集特定的变量（编码）。然后对编码进行了一致性审查，在每月的跨学科小组会议和“行动项目”中，确定并考虑实施。从2021年开始的任何12个月期间，每月大约有12-15个不同的病例进行审查和编码，提供充足的机会来识别趋势和模式。
结论：我们开发了一种创新流程，用于持续审查RRT-Code事件。审查过程易于实施，并且可以及时识别高价值的改进机会。
方法：一组在流程和质量改进方面具有专业知识的临床医生为快速响应事件审查制定了一个规范的分析计划，试点，然后迭代优化一个系统的过程，应用于所有后续案例进行审查。
结果：以有条理的方法招募和培训医院评审员。每个审阅者都进行了图表审阅以总结RRT事件，并为每个案例收集特定的变量（编码）。然后对编码进行了一致性审查，在每月的跨学科小组会议和“行动项目”中，确定并考虑实施。从2021年开始的任何12个月期间，每月大约有12-15个不同的病例进行审查和编码，提供充足的机会来识别趋势和模式。
结论：我们开发了一种创新流程，用于持续审查RRT-Code事件。审查过程易于实施，并且可以及时识别高价值的改进机会。
