In a commentary published in the September 22 issue of JAMA, Peter Pronovost, MD, PhD, and Eugene Litvak, PhD, question the proliferation of rapid response teams (RRTs), claiming they are just ”a quick fix to save patients who crash once they are moved out of intensive care units.” Pronovost and Litvak argue that hospitals need to determine why patients are not receiving adequate care in the first place and why beds are not being better managed.
Rapid response teams are usually sent to rescue patients who have been released from the ICU to the floor, where they receive less intensive care. The patients who then deteriorate, the authors claim, do so because they are not receiving the level of care they need. In some cases patients are released from the ICU because their beds are needed for a sicker patient.
The ICUs are not always overcrowded, although there are times—often in the middle of the day, in the middle of the week—when they are. When this happens difficult decisions have to be made, and a patient might be sent to an inadequate unit, where they are at greater risk of deterioration. Better management of patient flow and having surgeons spread operations out over the course of the week, thus easing the crunch on ICUs, would be a step toward improvement, the authors argue.
Pronovost worries the there is inadequate research on the usefulness of RRTs and is concerned lest hospitals are using them as a crutch instead of addressing deeper problems.