• Emma Peebles, Christian P Subbe, Paul Hughes, and Les Gemmell.
• Department of Critical Care Medicine, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 6TD, UK.
• Resuscitation. 2012 Jun 1;83(6):782-7.

BackgroundRapid Response Teams aim to accelerate recognition and treatment of acutely unwell patients. Delays in delivery might undermine efficiency of the intervention. Our understanding of the causes of these delays is, as yet, incomplete.AimTo identify modifiable causes of delays in the treatment of critically ill patients outside intensive care with a focus on factors amenable to system design.MethodsReview of care records and direct observation with process mapping of care delivered to 17 acutely unwell patients attended by a Rapid Response Team in a District General Hospital in the United Kingdom. Delays were defined as processes with no added value for patient care.ResultsEssential diagnostic and therapeutic procedures accounted for only 31% of time of care processes. Causes for delays could be classified into themes as (1) delays in call-out of the Rapid Response Team, (2) problems with team cohesion including poor communication and team efficiency and (3) lack of resources including lack of first line antibiotics, essential equipment, experienced staff and critical care beds.ConclusionWe identified a number of potentially modifiable causes for delays in care of acutely ill patients. Improved process design could include automated call-outs, a dedicated kit for emergency treatment in relevant clinical areas, increased usage of standard operating procedures and staff training using crew resource management techniques.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

7 keywords...

hide…