Pharmacists as members of the rapid response team

Purpose: Rapid response teams (RRT) have been developed to provide early therapy to patients identified with risk factors for cardiopulmonary arrest.  We sought to investigate the role a pharmacist could have as a member of the RRT.

Methods: Two pharmacists trained in critical care and emergency medicine proposed a pilot program to the members of the RRT.  The primary goal of the pilot program was to determine if a pharmacist as a member of the RRT could help to optimize pharmacotherapy and facilitate medication administration.  To evaluate these goals, the responding RRT pharmacist collected patient demographics, medications administered, and any pharmacotherapy recommendations.  Additional information of interest was the time commitment for pharmacist involvement.  The two pharmacists were added to the RRT alerts through the institution paging system and responded when in the hospital and available.  During response, one pharmacist was at the bedside with the RRT for patient evaluation, consult, chart review, and to facilitate medication administration.

Results: Between January and June 2012 the pharmacists responded to 29 RRT alerts.  Cases were respiratory (27.6%) or cardiac (24%) related most often.  A majority of patients (62%) required at least one medication during the RRT evaluation and a total of 36 medications were administered to these patients.  The pharmacists on the RRT performed 44 pharmacotherapy related interventions in 18 patients.  Specific interventions included medication facilitation (15), dose (13) or therapy (6) recommendations, and adding (6) or discontinuing (6) a medication.   In nine patients that did not have a direct pharmacotherapy related intervention, chart review was performed.  The pharmacists spent a median time of 15 minutes (IQR 16.25) for each RRT alert and a total of 562 minutes.

Conclusion:   With a minimal time commitment, pharmacists can be valuable members of the RRT.