Purpose: A quality improvement project to evaluate the utilization and effects of the rapid response team (RRT) and code blue activation at Harbor-UCLA Medical Center.

Methods: Retrospective chart analysis of RRT and code blue data during a 2-month period (07/29 - 09/30/2020) at Harbor-UCLA Medical Center. Out of the 196 available RRT and code blue calls, 100 of them met the inclusion criteria and represented non-repeat calls of unique patients. For each of the RRT and the code blue calls, vital signs 24 hours prior were assessed. The RRT activation guideline at Harbor-UCLA is as follows: heart rate <40 or >130, respiratory rate <8 or >28, systolic blood pressure < 90, O2 saturation <90% or clinical signs of deterioration.

Results: 52 out of 100 RRT and code blue calls had abnormal vital signs that met requirement for RRT activation 24 hours prior to the recorded RRT or code blue. Out of those 52 patients, 33% expired compared to 18% of patients with normal vital signs 24 hours prior to the recorded RRT or code blue activation (P-value = 0.056). In both groups, 29% of patients transferred to ICU after the RRT activation.

Conclusion: In the time period from 07/29 – 09/30/2020 not all vital signs that met requirement for RRT activation led to an activation at Harbor-UCLA. There was a higher mortality rate in the delayed RRT activation group compared to patients who had RRT activated during the first detected vital sign that met RRT activation criteria. However, there was no significant difference in the ICU transfer between patients in the delayed group compared to initially activated RRT.