Study examines efficacy of rapid-response teams

by Kalani Simpson, UNMC public relations | November 02, 2017

Image with caption: Shelby Kutty, M.D., Ph.D.

Shelby Kutty, M.D., Ph.D.

Shelby Kutty, M.D., Ph.D, UNMC Professor of Pediatrics and Internal Medicine, Cardiology, called his latest research publication "low-hanging fruit."

"The cost of the study is essentially zero dollars," he said.

Yet "It could have billions of dollars in implications."

And that is the power of checking to see if what we "know" to be true actually is true.

It was such a great idea -- interprofessional rapid-response teams, also known as "code teams," on call 24-7, available to save lives and prevent in-hospital cardiac arrest.

It was such a great idea that hospitals across the country started implementing these teams in the early- to mid-2000s. The Institute for Healthcare Improvement (IHI) gave these teams its stamp of approval, recommending code teams as part of one of its campaigns.

IHI's website says, "By February 2007, more than 2,100 U.S. hospitals had pledged to implement Rapid Response Teams as part of the Campaign, with more than 1,500 reporting that teams had been put into action."

Implementing, training and maintaining these teams was costly. But, it was such a great idea. It was logical. It was intuitive.

Health care professionals smacked themselves in the forehead. Why hadn't hospitals been doing this all along? Of course, these teams would make a difference in patient mortality.

But the actual numbers tell a different story.

Dr. Kutty is first author of a new landmark study published in an American Heart Association journal, Circulation. While doing health policy and quality improvement courses for his master's in health care management at Harvard, Dr. Kutty collaborated with Paul Chan, M.D., of the Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine. Dr. Chan is a renowned expert on cardiac arrest, quality and appropriateness of care. They studied patient outcomes using Pediatric Health Information System (PHIS) data.

And across 38 pediatric hospitals, before and after implementation of code teams, from 2000-2015, they did not find a marked improvement of mortality rates, as expected.

Instead, the meta-analysis said that the teams had resulted in no added advantage. Mortality rates did not improve beyond what was expected from temporal trends, Dr. Kutty said.

Dr. Kutty expects that the people who believe in these teams won't give up on them, and he isn't ready to, either.

"This may help hospitals structure better designs of code teams," he said.

Arwa Nasir
November 02, 2017 at 9:40 PM

Congratulations! Great work.