1. Rapid Response Team Utilisation <24 Hours Post Emergency Admissions By Ash Abeysekera Presented by: Bronwyn Griffin Princess Alexandra Hospital, UQ School of Medicine

2. Background National Emergency Access Target (NEAT) Do time improvements = quality improvements?

3. Background What else……..? Rapid Response Team (RRT) Including Cardiac Arrest (CA)

4. Project Aims 1.Compare ED LOS for a.Patients requiring emergency activation With b.Patients admitted through the ED that did not have an event 2.Describe Characteristics and outcomes of emergency activation

5. Methods Design: retrospective observational cohort study Setting: PAH Timeframe: June 1 st – Nov 30 th 2014 Databases 1.RRT and CA database (combined and separate) 2.EDIS 3.HBCIS Ethics

6. Results …

7. % of RRT activations within 24 hours of ED admission

8. Average ED LOS (minutes +/- 1SD) 393 433 439 233

9. NEAT compliance (%) All P=>0.05

10. Average Age (years +/- 1SD) 59 65 65 62

11. Results: Characteristics & Outcomes SBP<90 33.93% GCS 22.02% SpO2<90 18.45%

12. Gender distribution (n%) P= 0.217

13. Results: After hours ED presentation P>0.05

14. Results: Triage category P=0.002

15. Results: Diagnosis Admission diagnosis on EDIS – I-J ICD 10 codes are cardio-respiratory diagnoses – 61 patients (19.14%) from early RRT/CAT from ED admission group – 2994 patients (31.9%) from no RRT/CAT group – No significant differences in Age Gender After hours presentation ED LOS

16. Results: Mortality

17. Conclusion 1.79% of ED admissions have early RRT/CAT ED LOS was longer in the RRT patient group No evidence to suggest NEAT increases rate of RRT

18. THANK YOU! A big thank you to Ash Dr Andrew Staib Dr Rob Eley Mr David Moore PA Clinical informatics

19. References 1.Konrad, D., et al., Reducing in-hospital cardiac arrests and hospital mortality by introducing a medical emergency team. Intensive Care Med, 2010. 36(1): p. 100-6 2.Jones, D., et al., Introduction of Medical Emergency Teams in Australia and New Zealand: a multi-centre study. Crit Care, 2008. 12(2): p. R46. 3.Hillman, K., J. Chen, and D. Brown, A clinical model for Health Services Research-the Medical Emergency Team. J Crit Care, 2003. 18(3): p. 195-9. 4.Winters, B.D., et al., Rapid-response systems as a patient safety strategy: a systematic review. Ann Intern Med, 2013. 158(5 Pt 2): p. 417-25. 5.Lowthian, J.A., et al., Demand at the emergency department front door: 10-year trends in presentations. Med J Aust, 2012. 196: p. 128-32. 6.COAG, National Partnership Agreement on Improving Public Hospital Services, C.o.F.F. Relations, Editor. 2010, Commonwealth of Australia: Australia. 7.Australian Institute of Health and Welfare, Australian Hospital Statistics National Emergency Access and Elective Surgery Targets 2012. 2012, AIHW: Canberra. 8.Considine, J., D. Charlesworth, and J. Currey, Characteristics and outcomes of patients requiring rapid response system activation within hours of emergency admission. Crit Care Resusc, 2014. 16(3): p. 184-9. 9.Lovett, P.B., et al., Rapid response team activations within 24 hours of admission from the emergency department: an innovative approach for performance improvement. Acad Emerg Med, 2014. 21(6): p. 667-72. 10.Committee, R., Code Blue - Medical Emergency, in Clinical, R. Commitee, Editor. 2014, Princess Alexandra Hospital, Metro South Health: Australia. 11.Medical Emergency Team End-of-Life Care investigators, The timing of rapid-response team activations: A multicentre international study. Critical Care and Resuscitation, 2013. 15(1): p.

20. Results: Characteristics & Outcomes