What Attorneys Should Watch for When a Rapid Response Team Intervenes

When a medical patient’s condition deteriorates, a rapid response team (RRT) may intervene. But was it activated in time? Did the team follow protocols? The answers are in your client’s medical records. For attorneys handling personal injury or medical malpractice cases, understanding RRTs can be the key to proving causation and securing fair compensation.

What Are Medical Rapid Response Teams?

Medical rapid response teams, or medical emergency teams, are specialized healthcare providers trained to intervene when a patient shows signs of clinical deterioration.

Typically operating outside intensive care units (ICUs), RRTs often include ICU nurses acting as clinical experts. Their goal is to prevent adverse outcomes, such as cardiac arrest, by intervening at the first signs of clinical decline. Unlike code blue teams, which respond after emergencies occur, RRTs aim to stabilize patients before their condition worsens.

Components of a Rapid Response Team:

Afferent Team: Identifies warning signs and determines if an RRT should be activated.
Efferent Team: Provides medical intervention to prevent serious complications or death.

Criteria for activating a Rapid Response Team include:

Heart rate over 140/min or below 40/min
Respiratory rate over 28/min or below 8/min
Systolic blood pressure greater than 180 mmHg or below 90 mmHg
Oxygen saturation below 90% despite oxygen support
Acute change in mental status
Urine output less than 50 cc over 4 hours
A staff member’s urgent concern about the patient’s condition

Some hospitals also allow family members to activate RRTs, which could be relevant in cases where a patient’s loved ones sought help but were ignored or were never informed of this option, leading to adverse outcomes or death.

Are Rapid Response Teams Effective?

Since their introduction in the 1990s, and gaining popularity in the 2000s as part of the Institute for Healthcare Improvement’s 100,000 Lives Campaign, RRTs have become a standard feature in many hospitals.

The Joint Commission has also developed a system for hospital staff to request specialist assistance when a patient’s condition declines.

Still, studies on RRT effectiveness are mixed. Some research links RRTs to reduced mortality rates and fewer cardiorespiratory arrests, while others suggest much less impact. This raises debate over whether quick interventions are more effective than a thorough but time-intensive approach.

Factors That Impact Rapid Response Team Success

Variations in study results may stem from differences in the training, composition, and effectiveness of rapid response teams.

Here are 4 key factors that can impact RRT performance:

Institutional and cultural barriers: Professional hierarchies may discourage junior physicians and nurses from escalating care.
Delayed activation: Failure to recognize signs of clinical deterioration can lead to preventable harm.
Team composition and training: Some RRTs may be understaffed or lack the specialized training needed to address specific conditions.
Use of Early Warning Systems (EWS): Despite being designed to aid early detection, EWSs show little effect on hospital mortality rates, ICU admissions, or adverse events.

Additionally, beliefs that the afferent team must justify activation or should manage crises independently can create barriers. Delays also stem from unnecessary reporting or difficulty locating the emergency event.

What Improves Rapid Response Team Performance?

Critical care expertise: Critical care experts have shown improved outcomes in mortality rates and faster activation times for the efferent team.
Real-time patient monitoring: Instruments detecting vital sign changes in real time enhance outcomes.
Institution-specific protocols: Clearly defined procedures improve effectiveness.

While the core purpose of RRTs remain the same across hospitals, their success depends on the quality of team members and protocols in place.

Factors to Consider in Litigation

Medical records can provide critical evidence of how a hospital managed a patient’s care. These records can:

Provide and assist with evidence for causation: If opposing counsel argues that your client’s condition was pre-existing or unrelated to an original event, RRT documentation can show the immediate impact of your client’s deteriorating health status.
Highlight deviations from the standard of care: Delayed activation, improper interventions, or missing documentation may suggest negligence.
Expose systemic failures: Patterns of delayed or ineffective RRT activations can indicate broader institutional failures.

Key Factors in Cases Involving Rapid Response Teams

When reviewing RRT documentation, focus on:

Timeliness of activation: Did the team respond immediately, or were there delays?
Team composition: Were experienced critical care specialists involved?
Interventions provided: Were the appropriate actions taken to stabilize your client?
Documentation accuracy: Are there inconsistencies, missing notes, or vague descriptions?
Patient outcomes: Did the RRT intervention improve or worsen the patient’s condition?

Medical records are one of the most powerful tools in personal injury and medical malpractice cases. When an RRT is involved, they add another layer of complexity that attorneys must consider.

Your client’s medical records provide a real-time account of the emergency response, and can make the difference between a weak case and a compelling argument in court.

Integrity Legal Nurse Consulting PDX can help with medical record analysis, future cost projections, reasonableness of charges, medical provider liaison services, and more. Get expert support on your case by booking a free consultation with our team.

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