Rapid Response Team (RRT) in Critical Care

  • Ninotchka BrydgesEmail author
  • Tiffany Mundie
Reference work entry


Rapid response teams (RTTs) were initially established in the mid-1990s and expanded to the Institute for Health Improvement’s 100,000 lives campaign and a Joint Commission’s national patient safety goal. The aim of implementing RTT in any organizations was to improve patient safety and quality of care through identifying deterioration in patient status and intervening to stabilize the patient in a timely manner. Members of the RRT include multidisciplinary healthcare professionals who are trained in critical care and capable to provide advanced assessment and interventions and facilitate communication with the primary team. The RRT is called for specific physiologic changes or for a more generalized concern raised by bedside nurses, other providers, or even family members. More recently specialized subsets of RRTs have developed, including sepsis teams and pulmonary embolism response team, in which responders to a specific situation are experts in related field. In the oncologic setting, the RRTs face unique challenges related to this patient population’s underlying malignancy, specified treatments and complications, as well as comorbidities.


Rapid response team Medical emergency response team Sepsis Pulmonary embolism response team Acute care nurse practitioners Nursing Early resuscitation 


  1. 1.
    Aneman A, Frost SA, Parr MJ, Hillman KM. Characteristics and outcomes of patients admitted to ICU following activation of the medical emergency team: impact of introducing a two-tier response system. Crit Care Med. 2015;43(4):765–73.PubMedCrossRefGoogle Scholar
  2. 2.
    Angel M, Ghneim M, Song J, Brocker J, Tipton PH, Davis M. The effects of a rapid response team on decreasing cardiac arrest rates and improving outcomes for cardiac arrests outside critical care areas. Medsurg Nurs. 2016;25(3):153–9.PubMedGoogle Scholar
  3. 3.
    Astroth K, Woith WM, Stapleton SJ, Degitz RJ, Jenkins SH. Qualitative exploration of nurses’ decisions to activate rapid response teams. J Clin Nurs. 2013;22(19–20):2876–82.PubMedCrossRefGoogle Scholar
  4. 4.
    Austin CA, Hanzaker C, Stafford R, Mayer C, Culp L, Lin FC, Chang L. Utilization of rapid response resources and outcomes in a comprehensive cancer center. Crit Care Med. 2014;42(4):905–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Bergmeir C, Bilgrami I, Bain C, Webb GI, Orosz J, Pilcher D. Designing a more efficient, effective and safe Medical Emergency Team (MET) service using data analysis. PLoS One. 2017;12(12):e0188688.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD. The 100 000 lives campaign: setting a goal and a deadline for improving health care quality. JAMA. 2006;295(3):324–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Brown C, Drosdowsky A, Krishnasamy M. An exploration of medical emergency team intervention at the end of life for people with advanced cancer. Eur J Oncol Nurs. 2017;31:77–83.PubMedCrossRefGoogle Scholar
  8. 8.
    Fernando SM, Reardon PM, Scales DC, Murphy K, Tanuseputro P, Heyland DK, Kyeremanteng K. Prevalence, risk factors, and clinical consequences of recurrent activation of a rapid response team: a multicenter observational study. J Intensive Care Med. 2018; Scholar
  9. 9.
    Goldhill DR, Worthington L, Mulcahy A, Tarling M, Sumner A. The patient-at-risk team: identifying and managing seriously ill ward patients. Anaesthesia.-LONDON. 1999;54:853–60.PubMedCrossRefGoogle Scholar
  10. 10.
    Guirgis FW, Jones L, Esma R, Weiss A, McCurdy K, Ferreira J, … Gerdik C. Managing sepsis: electronic recognition, rapid response teams, and standardized care save lives. J Crit Care. 2017;40:296–302.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Huh JW, Lim CM, Koh Y, Lee J, Jung YK, Seo HS, Hong SB. Activation of a medical emergency team using an electronic medical recording–based screening system. Crit Care Med. 2014;42(4):801–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Institute for Healthcare Improvement. How to guide: deploy Rapid Response teams. 2008. Available at: Accessed 27 Mar 2018.
  13. 13.
    Institute for Healthcare Improvement. 5 million lives campaign. Last modified 2015. Available at: Accessed 28 Mar 2018.
  14. 14.
    Jones DA, DeVita MA, Bellomo R. Rapid-response teams. N Engl J Med. 2011;365(2):139–46.PubMedCrossRefGoogle Scholar
  15. 15.
    Jones D, Rubulotta F, Welch J. Rapid response teams improve outcomes: yes. Intensive Care Med. 2016;42:593–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Kabrhel C, Rosovsky R, Channick R, Jaff MR, Weinberg I, Sundt T, … Chang Y. A multidisciplinary pulmonary embolism response team: initial 30-month experience with a novel approach to delivery of care to patients with submassive and massive pulmonary embolism. Chest. 2016;150(2):384–93.PubMedCrossRefGoogle Scholar
  17. 17.
    Kim R, Passev J. Nursing education improves RRT team efficiency. Hosp Peer Rev. 2017;42(6):67–9.PubMedGoogle Scholar
  18. 18.
    Kapu AN, Wheeler AP, Lee B. Addition of acute care nurse practitioners to medical and surgical rapid response teams: a pilot project. Crit Care Nurse. 2014;34(1):51–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Lee A, Bishop G, Hillman KM, Daffurn K. The medical emergency team. Anesth Intensive Care. 1995;23(2):183–6.CrossRefGoogle Scholar
  20. 20.
    MD Anderson Cancer Center. Pulmonary embolism response team (PERT). 2017. Available at: Accessed 28 Mar 2018.
  21. 21.
    Parmar A, Richardson H, McKinlay D, Gibney RN, Bagshaw SM. Medical emergency team involvement in patients hospitalized with acute myeloid leukemia. Leuk Lymphoma. 2013;54(10):2236–42.PubMedCrossRefGoogle Scholar
  22. 22.
    Revere A, Eldridge N, Joint Commission on Accreditation of Healthcare Organizations. National patient safety goals for 2008. Top Patient Saf. 2008;12:1–4.Google Scholar
  23. 23.
    Reardon PM, Fernando SM, Murphy K, Rosenberg E, Kyeremanteng K. Factors associated with delayed rapid response team activation. J Crit Care. 2018;46:73–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Rosa RG, Tonietto TF, Duso BA, Maccari JG, de Oliveira RP, Rutzen W, … Cremonese RV. Mortality of adult critically ill subjects with cancer. Respir Care. 2017. Scholar
  25. 25.
    Shearer B, Marshall S, Buist MD, Finnigan M, Kitto S, Hore T, … Ramsay W. What stops hospital clinical staff from following protocols? An analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus Australian metropolitan healthcare service. BMJ Qual Saf. 2012. Scholar
  26. 26.
    Stelfox HT, Bagshaw SM, Gao S. Characteristics and outcomes for hospitalized patients with recurrent clinical deterioration and repeat medical emergency team activation. Crit Care Med. 2014;42(7):1601–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Thomas K, Force MV, Rasmussen D, Dodd D, Whildin S. Rapid response team challenges, solutions, benefits. Crit Care Nurse. 2007;27(1):20–7.PubMedGoogle Scholar
  28. 28.
    Tirkkonen J, Tamminen T, Skrifvars MB. Outcome of adult patients attended by rapid response teams: a systematic review of the literature. Resuscitation. 2017;112:43–52.PubMedCrossRefGoogle Scholar
  29. 29.
    Wunderink RG, Diederich ER, Caramez MP, Donnelly HK, Norwood SD, Kho A, Reed KD. Rapid response team-triggered procalcitonin measurement predicts infectious intensive care unit transfers. Crit Care Med. 2012;40(7):2090–5.PubMedCrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Anesthesia, Critical Care and Pain Medicine, Department of Critical Care and Respiratory CareThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Critical Care and Respiratory CareThe University of Texas MD Anderson Cancer CenterHoustonUSA

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