Home » New team of experts responds quickly to patients in crisis
September 18, 2009 – Texas Children’s Hospital
In April 2009, three-month-old Daniel Zuniga was diagnosed with leukemia and began several months of treatments for his cancer. Following one of his chemotherapy sessions, his tiny body had an unanticipated reaction to the medications—and his concerned mother, Maria Zuniga, promptly activated Texas Children’s newly created rapid response team. Within minutes, Daniel was surrounded by a team of critical care experts who were able to assess and stabilize his condition before it became life threatening.
Members of the rapid response team rushed in when Daniel Zuniga’s mother, Maria, made the call after her son had a reaction to his chemotherapy.
The Zunigas were the first family to activate the rapid response system at Texas Children’s Hospital, which originated through a planning committee three years earlier and was implemented hospital-wide in March 2008. The key component of enabling families to activate the service was rolled out floor-by-floor in March 2009 with the final floors activated last month. Daniel’s room was among the first to be able to mobilize the team.
“After his chemotherapy, we were in Daniel’s hospital room when I noticed his heart rate had decreased, he had broken out in blisters and he was very lethargic—I had never seen this before,” said Zuniga. “I had been given a pamphlet about the rapid response team, so I made the call. In a matter of minutes we were surrounded by 10 to 15 staff members who were examining him.”
Once the call was made, the appropriate medical staff members were notified via pager and they rushed to Daniel’s bedside within minutes.
“We have created a complex, yet efficient system to quickly identify and treat patients admitted to general inpatient care units when their health unexpectedly declines,” said Dr. Moushumi Sur, medical director of Texas Children’s rapid response system and assistant professor of Pediatrics in the critical care section at Baylor College of Medicine. “The rapid response team increases the staff’s ability to intervene and take intensive action before the child’s condition deteriorates irreversibly as well as assist with communication between families and caregivers.”
Any health care provider or family member can activate the rapid response team for a patient.
“This program was put into place by a multidisciplinary group to try to reduce the number of codes and to improve the outcomes of our patients who have medical emergencies,” said Lee Evey, director of Respiratory Care and extracorporeal membrane oxygenation services at Texas Children’s and co-chair of the rapid response team steering committee.
Extensive training has been provided to all bedside caregivers, and parents are given a brochure about this service when they arrive to their child’s hospital room.
“The responding team consists of a critical care-trained physician, nurse and respiratory therapist in addition to other caregivers including the chief resident and the resident taking care of the patient,” said Sur. “The nursing administrative coordinator helps transfer the patients to a higher level of care if required. The team is most often called for breathing problems and dropping oxygen levels, falling blood pressure, seizures, and pain that is hard to control. We also encourage anyone to call if they simply are worried about a child’s condition, without any clear, definitive signs of distress. On average, the team responds to 35 calls per month.”
This new system eliminates valuable time that previously was lost when a nurse had to go through a chain of command to get critical care experts to a patient’s bedside.
“The nurses are empowered by this system,” said Angela Morgan, nursing clinical specialist in Texas Children’s Pediatric Intensive Care Unit and member of the rapid response team’s planning committee. “Providers love it because it saves valuable time when it comes to urgent patient care.”
This course of action is exactly what prevented Daniel from suffering irreversible damage from his chemotherapy reaction.
“This system is about patient safety and family satisfaction, along with provision of staff support and education,” said Sur. “While it has meant additional workforce personnel and resource management, it is well worth it. The team has received tremendous support from all levels at the hospital.”
The Zunigas are thankful for the system, which allowed them to make a critical call when it came to Daniel’s health.
“The response was great,” said Zuniga. “We are very satisfied.”