What a Past Rapid Response Call Can Tell Us About a Patient’s Future
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By Dr Krishnaswamy Sundararajan, Director of Intensive Care, Royal Adelaide Hospital
As a clinician and researcher, I’ve always been interested in what we can learn from critical moments in a patient’s hospital journey. One of those moments is a Rapid Response Team (RRT) call. These events happen when a patient deteriorates unexpectedly on the ward, prompting an urgent review by a specialised team.
In our recent study, published in Australian Critical Care, my colleagues and I looked at what happens to patients long after that RRT call has ended. We followed patients who had experienced an RRT event, tracking their outcomes over the years.
Rapid Response Team Calls Are More Than a One-Off Event
RRT calls often involve patients who are vulnerable due to age, underlying illness, or complex medical conditions. For many, these events were not isolated incidents, but signs of a deeper clinical trajectory.
Patients who had an RRT call, although more likely to have longer hospital stays and a greater risk of death over time, almost half were still alive 5 years following their first RRT call.
Over the course of the study, we also observed that RRT calls became more common.
We saw a broader range of patients involved, including younger people and a growing number with Not for Resuscitation (NFR) orders already in place. Importantly, as the system matured and staff became more confident in managing these situations, outcomes improved.
Using Rapid Response Team Calls as a Signal to Reflect
One of the key takeaways from this research is that a past RRT call can serve as a powerful clinical signal. If a patient has needed an RRT review before, we should take that as an opportunity to pause and consider what it might mean going forward.
- Are we recognising early signs of decline?
- Can we intervene and alter the risk of further deterioration?
- Are we having the right conversations with patients and families?
- Are we giving people the chance to express what matters most to them?
Too often, discussions about goals of care happen too late, or not at all. We need not wait until “end-of-life” to have end of life discussions.
An RRT call might be one of the few moments where it feels natural to start that conversation, making sure we’re on the same page about goals of care.
In summary, an RRT call is never just a single moment, it can be a turning point.
By paying closer attention to these events, and by having the courage to talk about what comes next, we can offer care that is not only clinically sound, but deeply respectful of each person’s values and choices.
If you’re a clinician who wants to feel more prepared for these kinds of conversations, the End-of-Life Essentials Comprehensive Care topics include three excellent, free modules, and cover:
- Goals of Care at the End of Life
- Chronic Complex Illness End-of-Life Care
- Bereavement Care
These modules are short, accessible, and designed for real-world clinical practice.
A/Prof Krishnaswamy Sundararajan