Findings of the First ANZICS Conference on the Role of Intensive Care in Rapid Response Teams

Author:

Jones D.1,Hicks P.2,Currey J.3,Holmes J.4,Fennessy G. J.5,Hillman K.6,Psirides A.7,Rai S.8,Singh M. Y.9,Pilcher D. V.10,Bhonagiri D.11,Hart G. K.5,Fugaccia E.12

Affiliation:

1. DEPM Monash University, Intensive Care Unit, Austin Health, Melbourne, Victoria

2. Intensive Care Unit, The Wellington Regional Hospital, Wellington, New Zealand

3. School of Nursing and Midwifery, Deakin University, Melbourne, Victoria

4. Australian and New Zealand Intensive Care Society, Melbourne, Victoria

5. Department of Intensive Care, Austin Hospital, Heidelberg, Victoria

6. Liverpool Hospital and University of New South Wales (South West Sydney Clinical School), Sydney, New South Wales

7. Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand

8. The Canberra Hospital and Lecturer, Medical School, Australian National University, Canberra, Australian Capital Territory

9. Department of Intensive Care, The Canberra Hospital, Medical School, Australian National University, Canberra, Australian Capital Territory

10. Alfred Hospital and Monash University, Melbourne, Victoria

11. South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales

12. Concord Hospital, Sydney, New South Wales

Abstract

Rapid Response Teams (RRTs) are specialised teams introduced into hospitals to improve the outcomes of deteriorating ward patients. Although Rapid Response Systems (RRSs) were developed by the intensive care unit (ICU) community, there is variability in their delivery, and consultant involvement, supervision and leadership appears to be relatively infrequent. In July 2014, the Australian and New Zealand Intensive Care Society (ANZICS) convened the first conference on the role of intensive care medicine in RRTs in Australia and New Zealand. The conference explored RRSs in the broader role of patient safety, resourcing and staffing of RRTs, effect on ICU workload, different RRT models, the outcomes of RRT patients and original research projects in the area of RRSs. Issues around education and training of both ICU registrars and nurses were examined, and the role of team training explored. Measures to assess the effectiveness of the RRS and RRT at the level of health system and hospital, team performance and team effectiveness were discussed, and the need to develop a bi-national ANZICS RRT patient database was presented. Strategies to prevent patient deterioration in the ‘pre-RRT’ period were discussed, including education of ward nurses and doctors, as well as an overarching governance structure. The role of the ICU in deteriorating ward patients was debated and an integrated model of acute care presented. This article summarises the findings of the conference and presents recommendations on the role of intensive care medicine in RRTs in Australia and New Zealand.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine

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