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CS14
Who You Gonna Call? Making a Critical Response Team a Reality in a Small Community Hospital
By M. Gooding; Seton Northwest Hospital SETON Healthcare Network, Austin, Texas
For further information, please contact: mgooding@seton.org
Purpose: Patients often have several hours of instability or deteriorating status before an emergency situation exists. Our goal is to target these patients and intervene early to stabilize their condition. Our 113 bed community hospital faced many obstacles in trying to successfully initiate a critical response team (CRT). We developed an advanced assessment team of experienced critical care responders to assist staff RNs in assessment of patients with a change in status.
Description: Our ICU manager met with other department managers and with ICU, ER, and Respiratory (RT) staff to create a CRT response plan specific for our hospital. Concerns included minimal staffing, safe patient care while ICU CRT responders are off the unit, and plans for those times when the ICU staff is unable to respond to CRT calls. The CRT ICU nurse is available by phone. The ICU unit manager, night shift supervisor, ER charge nurse, IMC, or RT staffs are alerted by phone as needed either for possible short-term ICU coverage or to respond to the CRT when ICU cannot. As a resource, ICU staff created a CRT Book with copies of hospital emergency protocols, ACLS algorithms, chain of command information, and SBAR (Situation, Background, Assessment, Recommendation) report prompts.
Evaluation: A written form was created showing why a CRT was called, interventions, outcomes, physician response, and whether transfer to a higher level of care was needed and then ordered by the MD. Periodically, all staff involved in a particular CRT meet to critique and learn from what was done and to discuss what might have been done differently. Indications thus far are that the CRT program has decreased the percentage of codes in the non-critical care areas of the hospital and improved collaboration between hospital units.
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