The “Rapid Response Recognition Report” is a quarterly recognition of providers who are “remarkable examples of excellence” during rapid response events at UNCMC.
Effective utilization of the Adult Rapid Response System at UNC Medical Center is essential in the early detection of clinically worsening patients to ensure necessary resources are mobilized and adverse outcomes prevented. Rapid response events require teamwork, collaboration, closed loop communication, and respect for each other.
A Rapid Response
A 70-year-old man recovering from abdominal surgery in the hospital seemed to be doing well, but two days post-operatively, his heart rate rose, his blood pressure dropped, and his color changed. A nurse caring for this patient recognized these changes as early signs of a potential downward spiral and activated the hospital’s rapid response system. The rapid response team, composed of the rapid response nurse (a critical care nurse available to rush to the bedside), primary nurse, primary provider, respiratory therapist, and house supervisor, convened at the patient’s bedside. The team quickly determined the patient was experiencing atrial fibrillation and immediately initiated appropriate interventions. With these measures, the patient stabilized, was able to stay on the unit without escalation of care, and a potential crisis was averted.
“Rapid response systems are designed to detect clinical worsening in hospitalized patients so that we can get critical resources to them sooner rather than later. To be successful, the system must be activated early and often. When the rapid response team comes to a patient’s bedside, there has to be effective teamwork, communication, collaboration, and respect for others: we’ve shown that these elements improve outcomes,” said Dr. Evan Raff, Physician Chair of the UNCMC Adult Rapid Response Committee and Associate Professor in the Division of Hospital Medicine.
UNCMC’s Adult Rapid Response System produces positive clinical results, it benefits the organizational culture, and it reminds everyone that the most important thing is caring for the patient.
Instituting the Rapid Response Recognition Report
“With this quarterly report, we want to recognize stellar UNCMC providers who demonstrate remarkable examples of excellence,” said Dr. Raff.
These providers not only participate in, but also facilitate the following key components of a rapid response: introductions (names and roles) followed by a synopsis of the patient history and what led to the event, then a formal debrief (summary of interventions and ongoing plan of care) at the conclusion of the event.
Following is the list of providers by department for the third quarter. Please join in recognizing them and read what rapid response nurses had to say about their performance.
Department of Medicine:
Emily Sturkie, MD
- “She was so wonderful to work with. She appreciated and considered the recommendations from RT and nursing. She was a great communicator and advocate for her patient.”
Andrew De La Paz, MD
- “He was very prompt and responsive with a GI bleed that needed to go to MICU and VIR. He also made sure the patient had an ART line and central line and was proactive on making sure patient received blood.”
Leslie Appleton, MD, MPH
- “She did a fantastic job leading a rapid event. She took control of the room and made sure everyone was informed and addressed concerns. She also did some teaching with the newer residents.”
Department of Surgery:
Diego Hipolito Canario, MD
- “…Especially helpful and wonderful during a rapid… He was helpful and engaging and listening to nursing suggestions.”
Department of Neurology:
Alan Howard, MD and Siddharth Ninan, MBBS
- “They did a good job with communicating with staff and being flexible with the POC when the patient began to deteriorate…”
Jeremy Wells, MD and Siddharth Ninan, MBBS
- “They have done a really good job in Rapid Responses. Dr. Wells has been very receptive and considers what nursing and rapid RNs say and explaining why or why not that may work. He also has taken extra time to speak with the patients and their families to explain the plan of care. Dr. Ninan is very professional and does an exceptional job of making sure everyone is heard and communicating with people in the room.”
Department of Urology:
Asia Matthew-Onabanjo, MD
- “She did a great job and is just so kind to her patients. She is open to learning during Rapids and I look forward to working with her in the future!”