Lives are being saved at hospitals here thanks to the pairing of medical professionals into new crisis teams, Spokane-area nurse managers assert.


Three of the Spokane-areas four major hospitalsSacred Heart Medical Center, Holy Family Hospital, and Valley Hospital & Medical Centerhave started such rapid-response programs, which team up a critical-care nurse with a respiratory therapist to respond quickly when the condition of a patient outside of the intensive-care unit deteriorates rapidly. The fourth hospital, Deaconess Medical Center, plans to launch a rapid-response program in October.


So far, the young programs at Sacred Heart, Holy Family, and Valley are exceeding expectations.


I think our whole nation will look back at this and say, Oh my gosh, why didnt we do this earlier? says Patricia Sellars, assistant vice president of patient-care services at Valley Hospital.


A rapid-response team can be calledeither by being paged or through the hospitals intercom systemto any inpatient room outside of a hospitals intensive-care unit when a primary nurse determines that a patients condition is worsening. Changes in pulse, blood pressure, or respiratory rate, as well as decreased urine output or a drop in blood oxygen level, could signal that a patients condition is failing, Sellars says.


Such indicators could show that a patient is in danger of suffering a cardiac arrest or respiratory arrest, Sellars says. She says the amount of time between the onset of such symptoms and heart or lung failure can vary, but generally speaking, a hospital staff typically has two to three hours to treat patients and try to prevent what hospital workers refer to as going code, a term used to describe a patient who suffers cardiac or respiratory arrest.


What we want to do is early intervention, Sellars says. You do have a window of opportunity if you recognize it.


Once theyre notified by a primary nurse that a patient is sliding, the critical-care nurse and the respiratory therapist who are serving as the rapid-response team on a given shift will stop what theyre doing and go quickly to the patients room. Sellars says the team typically can get to the patient in under five minutes.


The team is supposed to contact the patients physician within five minutes after arriving at the patients room, but early on, it has authority to provide some care without a doctors approval.


The response team typically spends between 30 minutes and an hour assessing and treating each patient, Sellars says. In some cases, patients must be moved into an intensive-care unit after the teams visit, she says.


The rapid-response protocol is one of several promoted by the Cambridge, Mass.-based Institute for Health Care Improvement as part of the nonprofits 100,000 Lives campaign, an effort to encourage efficiencies that improve patient care and prevent avoidable deaths.


Hospitals here report that rapid-response teams are working out better than expected.


It has exceeded anybodys wildest dreams, says Pam Sheldon, Sacred Hearts rapid-response manager.


Sacred Heart launched its rapid-response program on Jan. 30, and Holy Family started its program shortly thereafter. In the Sacred Heart programs first six months, the response team was called upon 531 times, or about three times a day, Sheldon says. Of those patients, 162 were moved to a higher level of care.


When asked how many of those calls were false alarms, Sheldon says, We dont consider any call an inappropriate call. She says that any time a nurse has a concern, calling a rapid-response team is considered to be necessary.


Sacred Heart has reported a sizable decrease in the number of cardiac arrests and respiratory arrests that occurred in the hospital, but outside of the ICU, since it went to the team approach. For example, in June, the hospital reported 2.9 codes outside of the ICU for every 1,000 discharges. In the year-earlier month, it had 5.8 codes outside of the ICU for every 1,000 discharges.


Holy Family, which started its rapid response unit in February, has had comparable success, says spokeswoman Anne McKeon. The Holy Family rapid-response program averages about three calls a week.


Since the Holy Family program started, the number of codes hospitalwide has decreased to three for every 1,000 discharges from five for every 1,000 discharges, McKeon says.


Valley Hospital launched its program last month. Since July 1, the rapid-response team has been called seven times. Each incident resulted in a positive outcome, and no cardiac arrests or respiratory arrests have occurred outside of the hospitals ICU since the program started.


We just prevented these cases from extending into full arrest, Sellars says.


About 25 critical-care nurses at Sacred Heart work exclusively in shifts as part of a rapid-response team, Sheldon says.


All of the hospitals respiratory therapists are trained in rapid response and take turns covering shifts, leaving their regular duties for a rapid response when necessary.


At Valley, about 30 critical-care nurses are trained in rapid response and alternate to cover those calls, handing off their regular daily duties to another nurse when called upon. All of the hospitals respiratory therapists are trained in rapid response and cover shifts as well.


Sheryl Bergerud, head of the education department at Deaconess, says 25 of 40 critical-care nurses who will participate in Deaconess rapid-response program have undergone training, and the remaining 15 are scheduled to do so over the next month.


The hospital started its pilot program earlier this month, with several mock drills being performed before the program begins formally.


Contact Linn Parish at (509) 344-1266 or via e-mail at linnp@spokanejournal.com.