%0 Journal Article
%T Enhanced End©\of©\Life Care and RRTs
%A Artur Grigoriyan
%A MD
%A Constantine A. Manthous
%A MD
%A Cristina Gheorghe
%A MD
%A Rodrigo Vazquez
%A MD
%A Tatsiana Palvinskaya
%A MD
%A Yaw Amoateng©\Adjepong
%A MD
%A PhD
%J Journal of Hospital Medicine
%D 2009
%R 10.1002/jhm.451
%X Abstract HYPOTHESIS: Institution of a rapid response team (RRT) improves patients' quality of death (QOD). SETTING: A 425©\bed community teaching hospital. PATIENTS: All medical©\surgical patients whose end©\of©\life care was initiated on the hospital wards during the 8 months before (pre©\RRT) and after (post©\RRT) actuation. STUDY DESIGN: Retrospective cohort study. METHODS: Medical records of all patients were reviewed using a uniform data abstraction tool. Demographic information, diagnoses, physiologic and laboratory data, and outcomes were recorded. RESULTS: A total of 197 patients died in both the pre©\RRT and post©\RRT periods. There were no differences in age, sex, advance directives, ethnicity, or religion between groups. Restorative outcomes, including in©\hospital mortality (27 vs. 30/1000 admissions), unexpected transfers to intensive care (17 vs. 19/1000 admissions) and cardiac arrests (3 vs. 2.5/1000 admissions) were similar during the 2 periods. Outcomes, including formal comfort care only orders (68 vs. 46%), administration of opioids (68 vs. 43%), pain scores (3.0 ¡À 3.5 vs. 3.7 ¡À 3.2), patient distress (26 vs. 62%), and chaplain visits (72 vs. 60%), were significantly better in the post©\RRT period compared to the pre©\RRT period (all P < 0.05). During the post©\RRT period, 61 patients died with RRT care and 136 died without RRT care. End©\of©\life care outcomes were similar for these groups except more RRT patients had chaplain visits proximate to their deaths (80% vs. 68%; P = 0.0001). CONCLUSIONS: Institution of an RRT in our hospital had negligible impact on outcomes of patients whose goal was restorative care. Deployment of the RRT was associated with generally improved end©\of©\life pain management and psychosocial care. Journal of Hospital Medicine 2009;4:449¨C452. £¿ 2009 Society of Hospital Medicine
%U https://www.journalofhospitalmedicine.com/jhospmed/article/128101/enhanced-end-life-care-and-rrts