Enhancing Interdisciplinary Team Dynamics to Ensure Effective Rapid Response in Critical Situations

Abstract

Rapid response teams are initiatives created to enhance the safety of hospitalized patients experiencing rapid deterioration in their condition. These initiatives involve the identification of at-risk patients, immediate notification of a pre-trained response team, quick intervention by the response team, and continuous assessment and monitoring of the patient’s condition (DeVita et al., 2006). The initiation of rapid response is the responsibility of registered nurses, yet dependent on the utilization of a scoring system referred to as the Modified Early Warning Score (MEWS). MEWS serves as a straightforward bedside assessment tool, evaluating the patient's physiological condition through the assessment of six vital signs: heart rate, blood pressure, respiratory rate, core body temperature, cognitive status, and urine output (Gardner-Thorpe et al., 2006). Multiple research findings indicate that the implementation of rapid response systems leads to positive outcomes in terms of patient morbidity and mortality (Al-Omari et al., 2019; Gong et al., 2020). However, the process of rapid response, like any complex healthcare system, is not without flaws and challenges. Miscommunication between medical-surgical nurses, intensive care nurses, and physicians during rapid response events is challenged, where communication failure is a leading cause of adverse events within the healthcare system (Dayton & Henriksen, 2007). Addressing these communication challenges is essential for patient safety, to improve the effectiveness of rapid response teams. Pursuing the above, it is essential to develop this project to improve communication between healthcare providers during an event.

At the American University of Beirut Medical Center (AUBMC), the implementation of evidence-based practices to drive quality improvement and improve patient outcomes is fundamental for practicing health professionals and, more importantly, for nurses. Recognizing the importance of evidence-based practice in health care, this project aims to improve patient outcomes at AUBMC by addressing communication challenges and providing up-to-date knowledge and skills related to rapid response matters.

After gaining approval from the Clinical and Professional Development Center (CPDC) at the AUBMC, we will establish a multidisciplinary team comprising clinical nurse specialists, registered nurses, physicians, quality improvement personnel, and clinical educators. This team brings diverse perspectives and expertise to the educational initiative and will help disseminate the educational material.

The educational program will be designed to ensure that the rapid response team members have up-to-date knowledge, skills, and attitudes essential to enhance team dynamics and ensure effective communication between the designated members.

The timeline for the implementation of the project to enhance rapid response systems at AUBMC spans over 3 months. Beginning with project initiation and approval, the project progresses through phases such as team formation, revision of the available assessment tool, and development of an educational program. Implementation of the program, training, and evaluation follow, ensuring healthcare professionals acquire the knowledge and skills needed for effective rapid response.

Gagne’s instructional model (1985) will be used to guide the instructional process of this educational program, as this model targets five essential learning domains: content, intellectual skills, cognitive strategies, and psychomotor skills, such as physical assessment techniques and attitudes. The simulation will be integrated into the program to train health professionals on how to respond and communicate effectively during a rapid response scenario. A comprehensive literature review will be conducted to identify best practices and evidence-based approaches, thereby enhancing our daily practice. Evidence and insights gained from the search will be incorporated into the education plan.

Program evaluation ensues to include knowledge acquisition, practical application, and participants’ satisfaction with the program. Accordingly, the program will undergo assessments on several levels: initially, by measuring knowledge acquisition via simulated scenarios, followed by assessing the correct application by participants through mock codes, and finally evaluating participants’ satisfaction with the course material and instruction. Evaluating the implementation process of the updated rapid response will be done by direct observation from clinical nurse specialists, nurse managers, and nursing shift administrators during an actual event.

In conclusion, this project aims to enhance the efficiency of rapid response systems in healthcare, which plays a crucial role in safeguarding patients experiencing rapid clinical deterioration. Challenges related to communication persist, emphasizing the need for improvement. The project's goal is to improve team dynamics during rapid response events.