Friday, September 12, 2008

Rapid response roles spark controversy

What are the indications for calling the rapid response team? What is the role of hospitalists? When should the patient be handed back to the attending physician? What is the attending physician’s responsibility?

These are the current topics of conversation among hospitalist types trying to better define how RRTs should work as reported in Today’s Hospitalist. There were some common threads. Hospitalists are sometimes inappropriately put in the role of “house physicians” for all in hospital emergencies. The function of RRTs and the role of hospitalists need better definition.

I’ve previously expressed my skepticism on this issue, here and here. Joint Commission and IHI claim that RRTs save lives. Hospitals and hospitalist programs all across the country trumpet the success of their programs. Yet, the general concept of the RRT has not been vetted by high level evidence. When applied to limited situations (eg early goal directed therapy) RRTs may save lives, but no one can make the general claim that just because your hospital has a RRT lives will be saved.

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