How to get emergency help — in the hospital

Patients and those close to them — family members or advocates — often understand their condition enough to know when things are going downhill. If those concerns aren't being heard by the patient's primary care team in a hospital, it may be time to call for a rapid response team (RRT).

Usually, a member of the clinical staff initiates a call to the rapid response team, but in some hospital systems, patients, advocates and family members can activate the RRT.

Typically, you can do this from within a hospital by dialing O on the room phone, giving the room number and saying, “I need a rapid response team.” Some hospitals may have dedicated phone numbers or extensions.

With the week of March 12-18 being National Patient Safety Week, it's a good time to learn about rapid response teams, sometimes called “Condition Help” or “Condition H.”

Calling for a rapid response team or Condition H allows patients and families to request immediate help in cases of emergency or if, after speaking to a member of the health care team, they have serious concerns about the patient's condition, such as a noticeable medical change, uncontrolled bleeding, unresponsiveness or severe difficulty breathing.

The team usually includes nurses, respiratory therapists, pharmacists and emergency department personnel. Unlike the traditional “code blue” team, their job is to immediately assess and treat the patient with the goal of preventing a transfer to intensive care, cardiac arrest or death.

So, it's not something to do frivolously, such as when the nursing assistant isn't coming to help the patient to the bathroom or dinner is cold. Complaints like that can be directed to the hospital's ombudsman or patient advocate.

Here are some other scenarios that may justify a call to a rapid response team:

• A heart rate more than 140 beats per minute or less than 40

• Uncontrolled pain

• Chest pain

• Seizure

The first patient-empowered rapid response team was created 20 years ago at the University of Pittsburgh Medical Center Shadyside and Children's Hospital after the death in 2001 of 18-month-old Josie King at Johns Hopkins.

Josie's mother had repeatedly told her daughter's care team that she thought Josie, who was recovering from burns and about to be discharged, was severely dehydrated. The clinical staff had not responded to Josie's signs of dehydration, such as listlessness, thirst and weight loss, after she was removed from automatic nutrition and hydration.

“If there had been a rapid response team at the hospital that I had had the opportunity to call myself, I believe my daughter would be alive today,” King said. With the financial settlement from Johns Hopkins, she and her husband started the Josie King Foundation to advocate for patient safety measures and the reduction of medical errors.

A staff member at the Pittsburgh hospital, who had heard King speak, worked with her to devise a system that would allow patients and family members to bring their critical concerns to the attention of an emergency medical team, similar to calling 911 for help. During a one-year period, the hospital received only 20 Condition H calls, mostly from patients, and all were judged to have been appropriate.

Rapid response teams became more common in U.S. hospitals following the launch of the 100,000 Lives Campaign by the Institute for Healthcare Improvement. By 2007 more than 2,100 U.S. hospitals had pledged to implement rapid response teams.

Patient outcomes in hospital systems with patient- or family-activated rapid response teams have included reduced length of stay, fewer unanticipated ICU admissions and fewer episodes of cardiac arrest.

Although patients say they feel much safer knowing they can get immediate attention if they feel they need it, it might be difficult to find out whether your hospital has a patient-activated rapid-response team. It's not often easily found on websites, although hospitals are required to share the information. The best thing to do is to ask when you or your loved one is admitted. If there is one, find out how to contact them should the need arise.

Fortunately, most hospital stays are uneventful and a patient is able to return home without incident. But they're not all like that. Whether you are the patient, the family member or the advocate, familiarize yourself with your hospital's rapid response team policies and protocols to learn if you can take action in an emergency situation.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” ► Dec 2022; self publish ◄ is now available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (847) 612-6684.