Staff at North Central Bronx Hospital are taking to heart HHC’s goal to engage patients and their families as partners in healthcare and are teaming up with family members to help reduce cardiac arrest outside the ICU.

"Your family knows you best. So, if a family member feels something is wrong, we are advising them to go to a nurse or other member of the health team and ask for help," says Elizabeth K. Gerts, MS, RN, director of nursing for North Central Bronx Hospital. "If there is a problem, the Rapid Response Team (RRT) will be called to assess the situation and take all necessary steps to help the patient."

RRTs of doctors, nurses, respiratory therapists, transporters, and other clinical staff are activated to quickly treat patients identified as imminently at-risk for a cardiac arrest. A noticeable change in a patient’s breathing, temperature or other vital signs could trigger a call to the RRT. If warranted, patients are moved into the close monitoring of the ICU where the chances of preventing a cardiac arrest are greater.

NCB and Jacobi Medical Center, both part of the HHC North Bronx Healthcare Network, are reaching out to patients and their families through a brochure, information in their admissions packets, and posters in patient rooms, to tell family members about the signs and symptoms that they should be concerned about and the role of RRTs.

The posters advise families to notify a nurse when they become concerned about their loved one's medical condition, so a Rapid Response Team can be called. The symptoms they are asked to look for are:

• Weakness in face, arms, or legs
• Chest pain, discomfort, or fast heart beat
• Change in color of skin-pale or gray looking
• Sudden sweating
• Difficulty walking or speaking
• Change in mental status -- less awake than normal, or agitated
• Sudden loss of consciousness or a collapse
• Bleeding or a seizure
• Any noticeable change in the way they look or feel

"Involving family members empowers them and allows them to feel more positive about the hospital experience," Gerts says.

Gerts says that North Central Bronx Hospital, which has about 200 beds, averages 13-14 RRT calls monthly. Larger hospitals in the HHC system average about 70 calls a month.

Rapid Response Teams, which were first recommended by the Institute for Healthcare Improvement, are part of HHC's campaign to become one of the safest health systems in the country by 2010. RRTs are now in place at all 11 HHC hospitals. They are one of many best practices HHC is implementing in its corporate wide patient safety efforts.

March 2008