Condition Help/ Rapid Response providers

[OhioCVRN]

Help! I need any new data regarding Condition H(elp), a pro-active program developed in 2005 at UPMC Shadyside. Starting Monday, our 400 bed hospital is trialing this concept on a 35 bed medical unit, with plans to go house-wide by the beginning of 2009. Patients and families are encouraged to initiate a Code H based on guidelines :

* if a noticeable change in the patient's condition occurs and the health care team isn't responsive to either the change itself or to patient and family concerns,

* if there is a breakdown in how care is being given or confusion over what needs to be done

* if both of these occur.

Our facility does not have a dedicated rapid response team. Our RRT consists of a critical care nurse, respiratory therapist, house physician and nursing management who all respond from their regularly assigned duties. Our program will announce these new calls as rapid reponses, and our RRT team must now respond to these calls, as well as true Rapid Responses called by hospital staff, Dr. Stats and Code Blues, while also maintaining a full assignment in our own critical care unit.

Our hospital has had a RRT for over a year and even though I groan when I'm handed the RRT beeper, I understand the importance of possibly averting medical crisis and handling situations before pt conditions deteriorate. But the initial data on this new pt/family concept seemed to be more customer-related issues and lack of communication between patients and care-givers, things that did NOT require a critical care team to handle the problem to the patient's or family's satisfaction. And while I am out on a call from a disgruntled patient, MY ICU patients are being 'covered' by already over-stretched staff members that are trying to keep up with their own assignments. So how long before MY patients become disgruntled and upset?

This program went live at UPMC in 2006. It is now October of 2008, and I am trying to find new data on the number and types of calls, the time of day they were called, and general responses to this program from people who have been involved in these Code H calls, either at UPMC or any hospital that is providing this program. Does anyone have any new data or opinions on the "Code H" calls? I'd really appreciate any input!

[cloister]

Our hospital started Condition H last year. It was decided that the house supervisor would respond on nights and patient relations on days, mainly to make sure that ICU nurses weren't trucking upstairs to hear disgruntled family members bleat about Granny's lost dentures or other non clinical issues. In the year that we've had the program, we've had maybe two calls and both were of a non clinical nature. Should it turn out to be clinical, a rapid response is called (overhead, in our hospital).

I don't think I'd get too stewed about it. I was the lone curmudgeon at the hospital wide practice council that put this puppy into place, and my reasoning was like yours - I don't want to be doing patient relations and service recovery in the middle of the night. It's turned out to be not such a big deal.

Hope this helps.

[rjflyn, ASN, RN]

I have to say our facility has had it for a while as well and just found out about the stats a couple days ago. For one we need to give our pt's family a little more credit than we do. My facility gives them a pamphlet on admission that explains the program. That said in a years time in a fairly large hospital we have had count them 2, yes thats 2 code H's. We have more people inadvertently hitting code buttons in a day than that which since I work in the ED and we respond to codes with a nurse and MD are more annoying.

Rj