C56-39 Optimization of Resident Rapid Response Time

Rationale With the advent and widespread use of secure messaging, early empirical evidence suggests improved provider communication in the inpatient setting. However, resident physicians at the University of Michigan anecdotally expressed frustration with mis-triaging of secure messaging versus use of pages for important clinical updates or questions - most specifically with notification of rapid responses (RRTs) - thereby delaying clinical actions. No clear data exists on secure chat communication during these critical times. This project aims to improve this process and response times to RRTs. Methods Chart review of 100 random RRTs from 2023 resident only teams was conducted. Specifically, the time from initiation of RRT to time of resident provider/”physician in charge” was noted (response time). Additionally, resident physicians from the University of Michigan Internal Medicine program were surveyed to better understand resident perceptions of safety of RRT notification modalities as well as perceived factors affecting time of arrival to RRT. Based on data, the hospital implemented a protocol for the first contact provider to be automatically paged when RRTs are called via paging operator. Follow up chart review of 100 random RRTs of resident-only teams in the one year following intervention implementation was done focusing on response time. Independent samples t-test & frequency analysis was performed with SPSS. Results Prior to intervention implementation, in 13.8% of RRTs called on general medicine resident patients, the resident physician arrived to bedside greater than 10 minutes after the RRT had been called with an average response time of 4.92 minutes. Per survey data, residents believed that being notified by secure chat messaged significantly contributed to delays in response time with RRTs. Surveys also showed that residents found secure chat messaging to be a highly unsafe modality when notifying providers of RRTs versus pager which was thought to be highly safe.Following intervention implementation, in 5.43% of RRTs called on general medicine resident patients, the resident physician arrived to bedside greater than 10 minutes after the RRT had been called with an average response time of 3 minutes (p < 0.01). Conclusion Following the implementation of standardized paging to the first contact resident physician, there was a statistically significant difference in response times between pre- and post-intervention. There were less than half as many RRTs in reviewed cases with resident providers arriving in 10 minutes or greater after RRT initiation. This intervention allowed for quicker notification of resident physicians about RRTs happening for their patients. This abstract is funded by: None