C22-13 Feasibility and Early Outcomes of Integrating Critical Care Providers Into Rapid Response Teams: A Pilot Study

Abstract Introduction Rapid response (RRT) systems are used to respond to acute clinical changes among patients not in the intensive care unit (ICU). RRT members can either help stabilize the patient or guide transitions to a higher level of care. While prior studies have demonstrated improved patient safety with the existence of an RRT infrastructure, there is no consensus in the literature on optimal composition of the team. This study sought to understand the feasibility and impact of having a designated critical care provider respond to RRT activations. Methods A proof-of-concept pilot integrating critical care providers into a nurse-driven RRT model was implemented at a single-center academic tertiary hospital over four weeks from May-June 2025. Either an advanced practice provider or an attending physician responded to all daytime RRT activations on designated units, including medicine, oncology, cardiology, and observation. Following the pilot, a survey was conducted among staff who responded to RRT activations or participated in the events. Patient-level data from this pilot was compared to a six-month retrospective cohort of daytime RRT activations from March-August 2024, which served as the control group. T-testing and chi-square testing were utilized with statistical significance set at a p-value of 0.05. Results During the pilot period, 31 RRT activations occurred for 29 unique patients. Of the pilot RRT events, 11 resulted in escalation of care to the ICU. In the control group, there were a total of 343 RRT activations for 282 unique patients. Compared to the control group, the overall ICU transfer rate for RRTs with a critical care provider was lower (35.5% vs 53.4%, p = 0.057). For patients transferred to the ICU, fewer had an ICU stay that was shorter than 48 hours (27.3% vs 45.9%, p = 0.229). Among 58 provider survey responses following the pilot, 80% agreed that adding a dedicated provider to the RRT facilitated communication with the primary team, improved coordination of care, and decreased the stress/chaos of the RRT event. Conclusions Critical care providers can effectively facilitate communication and coordination of care for patients exhibiting clinical deterioration outside the ICU. Although this pilot project was limited by short duration and small sample size, it demonstrates that this staffing model is feasible and may reduce ICU transfer rates as well as the number of ICU short-stay patients. Further investigation is warranted to determine the role of including a dedicated critical care provider in RRTs, particularly in the academic tertiary care setting. This abstract is funded by: None