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Condition H allows family activation of a rapid re - sponse team in a hospital setting. Systematic implementation of Condition H at a 500-bed Magnet® community hospital led to varied types of calls, all of which met the policy criteria. Many communication issues were discovered through this process.
At an Institute of Healthcare Improvement meeting in 2002, Sorrell King told the story of her 18-month old daughter Josie's death in the hospital following a series of unfortunate errors (King, 2002). Initially, Josie was admitted to the hospital for burns suffered from stepping into a hot bath. She made good progress and was admitted to a stepdown unit. However, she was re-admitted to intensive care, where several errors were made and her condition began to deteriorate. Sorrell's story elucidated her sense of powerlessness and frustration as she tried to alert staff to changes in her daughter's condition that led ultimately to her death. The Josie King story has been discussed in multiple health care settings, and has led to changes in many hospitals regarding receptivity to feedback by parents and others related to potential care issues for patients. One such change is family activation of rapid response teams (RRTs) for medical emergencies.
Rapid Response Teams
Hospital-based RRTs are groups of health care professionals who are called to help hospital staff when a patient's condition is deteriorating. They are different from resuscitation teams in that they are called prior to cardiac or respiratory arrest. RRTs were formed because not all staff members are prepared to intervene in these situations, which can occur outside critical or emergency care settings. In addition, some situations in which patients experience cardiac arrest or are transferred to intensive care are presaged by clinical indicators that could have triggered earlier interventions (McCabe, 2007). Driving the formation of RRTs in hospitals across the United States was the Institute for Healthcare Improvement's 100,000 Lives Campaign (Berwick, Calkins, McCannon, & Hackbarth, 2006). RRT implementation was one of six strategies developed to prevent inhospital deaths. The other strategies included the following: (a) deliver reliable, evidence-based care for patients following acute myocardial infarction; (b) prevent adverse drug events through medication reconciliation; and (c) prevent central line infections, surgical site infections, and ventilator-associated pneumonia (Berwick et al., 2006).