Performing Rapid Response Teams, the first in Viet Nam health care

Rapid response team(RRT) program has been established in many hospitals all over the world, especially in the United States, UK, Australia. In Purpose of improving patient safety and Prevention adverse events and patient deaths in hospitals with slogan “ the patient is the center” .Vinmec Hospital decided to perform RRT system with suggesting from Professional Cristopher Farmer and designed following the Institute for Healthcare Improvement (IHI).

At Vinmec, In – Hospital Cardiac arrest requiring Cardiopulmonary resuscitation attack 5-6 cases/year. Addition, the patients with deteriorated condition detected lately were difficult to recover after transferring to ICU. RRT can recognize early identification and intervention for deteriorated patients. The RRT system at Vinmec is the first in Viet Nam, following with success we want to extend to others hospital to get improving in quality of Viet Nam health care.

Conditions of deployment:

• Team Leader is the ICU doctors in the duty session
• ICU RRT: are the ICU nurses involved in the daily shift (1 or 2)
• Activator is a nurse working in the department in shifts, at least 1 Activator working in shift duty and requires 24/24 to have Activator (initially selected as the chief nurses for training)

Training: Training on using Mews score, head to toe examination skills, knowledge of: Circulatory, respiratory, neurological, sepsis. Training program ~ 2 days with simulation program

Hospital directors have to put the RRT program into the key program that needs to be implemented to improve the patient safety system

100% RRT activators got change in confidence when face to deterioration patient after training. From 4/2019 to 12/2020 we reported 187 calls for help with Mews score range from 3-5 points, most from Internal, Oncology and Cardiovascular departments with 100% ICU RRT response come to support within 5 minutes. The major reason for RRT calls are respiratory and cardiac status.

All patients (ICU and ward room) received primary treatment at bedside including oxygen therapy, blood pressure management and 1-hour bundle in sepsis. There was 60% patient can continue stay at ward after intervention. Especially during 2 years we haven’t got In-hospital cardiac arrest.

We continue collect data to analysis about risk for AKI, costing and length of stay hospital for patient had RRT call.

RRT program training is useful in providing critical care skill for responders which is not within in their usual scope of education and practice daily. We get the target of training 100% nurse can be RRT Activator at Vinmec hospital this year and train more bedside critical care skills how to decrease the number of cardiac arrest. Interdisciplinary team can be implement this year base on RRT+ physician + ICU staff + pharmacist to provide best care for patient, facilitate nurse confedence and quality of hospital.

The establishment of RRTs has early reported that it is positive on In -hospital cardiac arrest number and patient outcomes. Activator nurses with high confidence were promoted to practice critical care therapies on Patients who deserve the best quality care at Vinmec.