Resource use, governance and case load of rapid response teams in Australia and New Zealand in 2014

Abstract

Background: Rapid response teams (RRTs) are a mandatory element of Australian national health care policy. However, the uptake, resourcing, case load and funding of RRTs in Australian and New Zealand hospitals remain unknown. Aim: To assess the clinical activity, funding, staffing and governance of RRTs in Australian and New Zealand hospitals. Methods: Survey of Australian and New Zealand hospitals as part of a biannual audit of intensive care resources and capacity. Results: Of 207 hospitals surveyed, 165 (79.7%) participated, including 22 (13.3%) from New Zealand. RRTs were present in 138/143 (95.5%) Australian and 11/22 (50%) New Zealand hospitals equipped with intensive care units (P < 0.001). Additional funding was provided in 43/146 hospitals (29.4%) but was more likely in tertiary ICUs (P < 0.001) and in New Zealand (P = 0.012). ICU staff participated in 147/148 RRTs (99.3%), which involved medical staff only (10.2%), nursing staff only (6.8%), and both medical and nursing staff (76.2%). Isolated ICU nursing involvement was more common in smaller ICUs (P = 0.005), in rural/regional and metropolitan hospitals (P = 0.04), and in New Zealand (P = 0.006). Dedicated ICU outreach registrars and consultants were present in 19/146 hospitals (13.0%) and 14/145 hospitals (9.7%), respectively. The ICU provided oversight for 122/147 RRTs (83%). In the 2013–14 financial year, there were more than 104 000 RRT calls. Conclusion: In cases where data were known, ICU staff provided staff for most RRTs, and oversight for more than 80% of RRTs. However, additional funding for ICU RRT staff and dedicated doctors was relatively uncommon