October 30, 2009

New system lets families initiate rapid response team

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Anne Ussery, left, and her daughter, Elizabeth, took part in efforts to create Vanderbilt’s Family Initiated Rapid Response Team program. (photo by Anne Rayner)

New system lets families initiate rapid response team

When a family member in a patient's room suspects their loved one's condition is rapidly worsening or a serious new health concern is developing, their instincts are often correct.

A new system at Vanderbilt gives families a powerful tool to quickly call for help.

The Family Initiated Rapid Response Team program is a lot like calling 911, but when a family member dials 11111 from a Vanderbilt patient's room, a LifeFlight operator dispatches the rapid response team.

The Family Initiated Rapid Response Team program rolled out in all non-intensive care patient units for Vanderbilt University Hospital in August, and this month at the Monroe Carell Jr. Children's Hospital at Vanderbilt.

“There are situations when things may change so quickly the family may pick up on it before the bedside nurse can,” said Brad Strohler, M.D., assistant professor of Pediatrics and Anesthesiology in Pediatric Critical Care, and chair of the Rapid Response Committee at Children's Hospital.

“The rapid response team works with the family and primary care team to provide another eye on the patient.”

At Children's Hospital, the program is called the Family Initiated Rapid Support Team, or FIRST. The team is made up of volunteer staff from the Pediatric Critical Care Unit.

Recently, signs went up in every non-critical care patient room telling families that they can dial 11111 from their patient room to report life-threatening changes in a patient's condition, or if they fear a situation is becoming a medical emergency.

“There are times in every hospital setting when the process of evaluating a patient might be delayed for some reason. While it is rare, it is a good idea and an important thing to do to partner with families this way,” said Jenny Slayton, R.N., administrative director of Performance Management and Improvement.

Anne Ussery is a member of the Family Advisory Council (FAC) at Children's Hospital. The FAC worked with Children's Hospital officials to craft language for educational materials to explain FIRST to parents.

Ussery said families trust the medical team, but sometimes a child doesn't fit easily into standard criteria.

“The point is medical standards might not trigger an alarm, but a mothers' instincts are pretty accurate when things are not right. If you have that “gut feeling,” this is another resource,” Ussery said.

There were initial concerns the system might be abused and non-emergency calls might tax the response team.

“But we found that did not happen,” said Brent Lemonds, R.N., administrative director of Emergency Services and Specialty Nursing at VUH. Lemonds headed up a pilot of the program at VUH last spring.

He said only one of the six calls from family during the pilot were non-emergent.

In most cases, the patients ended up needing transfer to an intensive care unit. One patient even ended up having emergency surgery.

“Rather than seeing abuse of the system, we found the vast majority of family members respect it like they do calling 911 at home,” Lemonds said.