RRS

International RRS Survey, May 10-11, 2010

Dear attendee to the 6th international symposium on Rapid Response Systems,

In preparation to the 6th international conference on Rapid Response Systems (RRS), we would like to invite you to complete this short survey before the start of the conference. The goal of this survey is to analyze the content of RRS across the globe.
Because little is known about the differences between hospitals within one country but also differences between countries/continents, we would like to investigate this with our survey.

The content will be used (anonymously) for conference purposes but (depending on quality and response rate) may also be used for publication into an international scientific journal.
This survey was developed within the Netherlands by the COMET-study group (The Cost-effectiveness analysis of medical Emergency Teams) in close collaboration with Michael DeVita from Pittsburgh.

Please complete this survey by April 30, 2010.

Kinds regards,

Jeroen Ludikhuize, MD
The Academic Medical Center (AMC),
Amsterdam, NL

Bernard Fikkers, MD, PhD
Radboud University Medical Center,
Nijmegen, NL

Michael DeVita, MD
West Penn Allegheny Health System
Pittsburgh, Pennsylvania, USA

Francesca Rubulotta
Imperial College
Charing Cross Hospital London, UK

I refuse/decline to participate in this survey:

Yes, because our institution/hospital will not provide any RRS type service in the near (within next 6 months) future.
Other:

Name of Institution (optional) We request the institution name to allow us to identify multiple responses from a single organization. We will not divulge any institutional information

Demographic data:

2. How many ICU admissions are there annually within your institution/hospital? (Please provide this information for the year 2009)

3. Does your institution/hospital provide an RRS type service?

Yes
No

If the answer to 3 is “yes”, what YEAR was this service operational in your institution/hospital?

If the answer to 3 is “yes”, what Month was this service operational in your institution/hospital?

The Afferent Limb:

4. What kind of system does your institution/hospital employ? Can you point out which of the following two systems resembles your system the most? (No exact match necessary and see definitions on page 2!)

Figure 1, Single parameter system
Figure 2, Aggregated (weighted) TT system
Other:

5. Can you send us a copy of your Track and Trigger system?

Yes
No

Please send plans to:
RRS Surveys
125 Dewey Street
Edgewood, PA 15218-1407

6. Do you use a standard hand off or report system to improve communication about (critically ill) patients between nurses and doctors?

Yes
No

If the answer to 6 is “yes”,, what is the name of this communication tool/system?

SBAR (Situation-Background-Assessment-Recommendation)
RSVP (Reason-Story-Vital signs-Plan)
AMPLE (Allergies-Medicines-Past history-Last meal-Event)
Other:

7. Is there a protocol for measurement of physiological parameters within your hospital on the nursing wards?

On the basis of clinical sight of the respective nurse/doctor i.e. “ on clinical grounds”
All parameters within the TT are routinely performed on all patients 2-3 times a day
No standardisation, totally left on the discretion of the nurse
Other:

The Efferent Limb:

8. What type of efferent limb do you currently use?

MET (Medical Emergency Team; a physician led team)
RRT (Rapid Response Team; a team without a physician first responder)
CCOT (Critical Care Outreach Team, any team that has routine visits to high risk patients in addition to critical responses)
Other:

9. On what basis is your response team available in your institution/hospital?

24/7
Monday to Friday 24 hrs a day, weekends not available
During weekdays from ± 8 am tot ± 10 pm
Only during office hours from roughly 8 pm till 5 pm
Other:

10. What is the primary (i.e. directly on call out) composition of your response team?

Only nurses
Only nurses with (critical care) doctors on call if needed
Nurses and (critical care, hospitalists, or other specialty) physicians simultaneously
Other:

11. Who is authorized to activate the Rapid Response System?

Only doctors
Primarily doctors, but when not reachable or no response, also nurses
Doctors AND nurses
Everybody, including relatives, paramedical and other personnel

The Administrative Limb:

12. Does your hospital employ a specific Rapid Response System coordinator who has primary responsibility for the RRS? (The person may have other responsibilities as well)

Yes
No (proceed to # 13)

13. Do you carry out specific data collection for the analysis of the rapid response system’s effectiveness?

Yes
No

If the answer to 13 is “yes”, which parameters do you systematically document/analyse with your institution/hospital? (Multiple answers are possible!)

Number of rapid response system activations (excluding cardiac arrests)
Number of cardiac arrests
Number of unplanned ICU admissions
Number of deceased patient with or without code restrictions
Other:

If the answer to 13 is “yes”, when you monitor these parameters, do you use a denominator?

Yes
No

If the answer to 13 is “yes”, which denominator do you use?

Number of discharged patients
Number of admitted patients
Number per week/month/year etc.
Other:

What is your opinion on…?

Can you, on an eleven point scale from -5 to 5 point out your opinion in regard to the following statements/questions? Please select your grade from the pull down list.

14. How do you value the RRS within you institution/hospital? *

15. Does the presence of the RRS lead to higher satisfaction of the nurses on the wards? * Please choose your grade from -5 (Totally disagree) to 5 (Totally agree)

16. The maintenance of a RRS costs a lot of effort. * Please choose your grade from -5 (Totally disagree) to 5 (Totally agree)

17. In your opinion, does the introduction of a RRS lead to unbalanced increase in workload in respect to health benefit/patient safety? * Please choose your grade from -5 (Totally disagree) to 5 (Totally agree)

18. Any closing remarks?