Resource use, governance and case load of rapid response teams in Australia and New Zealand in 2014.

Authors:
  • JSJoint College of Intensive Care Medicine and Australian and New Zealand Intensive Care Society Special Interest Group on Rapid Response Systems
    Joint College of Intensive Care Medicine and Australian and New Zealand Intensive Care Society Special Interest Group on Rapid Response Systems
  • AEAnzics Centre For Outcome And Resource Evaluation
    Anzics Centre For Outcome And Resource Evaluation
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  • 1 December 2016
    • journal article
    • research article
Abstract
Rapid response teams (RRTs) are a mandatory element of Australian national health care policy. However, the uptake, resourcing, case load and funding of RRTs in Australian and New Zealand hospitals remain unknown. To assess the clinical activity, funding, staffing and governance of RRTs in Australian and New Zealand hospitals. Survey of Australian and New Zealand hospitals as part of a biannual audit of intensive care resources and capacity. Of 207 hospitals surveyed, 165 (79.7%) participated, including 22 (13.3%) from New Zealand. RRTs were present in 138/143 (95.5%) Australian and 11/22 (50%) New Zealand hospitals equipped with intensive care units (P < 0.001). Additional funding was provided in 43/146 hospitals (29.4%) but was more likely in tertiary ICUs (P < 0.001) and in New Zealand (P = 0.012). ICU staff participated in 147/148 RRTs (99.3%), which involved medical staff only (10.2%), nursing staff only (6.8%), and both medical and nursing staff (76.2%). Isolated ICU nursing involvement was more common in smaller ICUs (P = 0.005), in rural/regional and metropolitan hospitals (P = 0.04), and in New Zealand (P = 0.006). Dedicated ICU outreach registrars and consultants were present in 19/146 hospitals (13.0%) and 14/145 hospitals (9.7%), respectively. The ICU provided oversight for 122/147 RRTs (83%). In the 2013-14 financial year, there were more than 104 000 RRT calls. In cases where data were known, ICU staff provided staff for most RRTs, and oversight for more than 80% of RRTs. However, additional funding for ICU RRT staff and dedicated doctors was relatively uncommon.