Kim MM, Barnato AE, Angus DC, Fleisher LF, Kahn JM. The effect of multidisciplinary care teams on intensive care unit mortality. Archives of Internal Medicine. 2010;170(4):369-376.

This population-based retrospective cohort study in acute care hospitals reports that multidisciplinary care teams appear to be associated with a lower risk of death among patients in the intensive care unit. The authors state that multidisciplinary rounds improve communication among providers and may facilitate implementation of best clinical practices, and pharmacist participation on rounds is associated with fewer adverse drug events.

Duncan KD, Kelly M, Sherman S, Levine C. Rapid Response Teams: Success and lessons learned. NRC Picker Focus. August 2009:1-6.

This article presents keys to successfully implementing Rapid Response Teams, as articulated by the IHI 5 Million Lives Campaign. Case studies from three organizations are also shared.

Cherry K, Martinek J, Esleck S, Ivory A, Logan R, Ward J. Developing and evaluating a trigger response system. Joint Commission Journal on Quality and Patient Safety. 2009 Jun;35(6):331-338.

A streamlined, organized, real-time trigger response system was developed that enabled quality measures targets to be achieved, including decreased response time. The simultaneous versus sequential trigger response process fostered a team approach to patient safety that leverages the clinical expertise of nursing and respiratory therapy. Implementation considerations, process improvements, and early outcomes are shared.

NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. New England Journal of Medicine. 2009 Mar 26;360(13):1283-1297. Epub 2009 Mar 24.

The NICE-SUGAR (Normoglycaemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation) Study was a large, international, randomized trial. The study found that intensive glucose control increased mortality among adults in the intensive care unit: a blood glucose target of 180 mg or less per deciliter resulted in lower mortality than did a target of 81 to 108 mg per deciliter.

Chen J, Bellomo R, Flabouris A, Hillman K, Finfer S; MERIT Study Investigators for the Simpson Centre; ANZICS Clinical Trials Group. The relationship between early emergency team calls and serious adverse events. Critical Care Medicine. 2009 Jan;37(1):148-153.

This cluster randomized controlled trial of medical emergency team implementation (the MERIT study) examines the relationship between early emergency team calls and the incidence of serious adverse events — cardiac arrests, deaths, and unplanned admissions to an intensive care unit. The study found that as the proportion of early emergency team calls increases, the rate of cardiac arrests and unexpected deaths decreases.

Federico FA. The new "rapid responder." Nursing Management Pharmacy Solutions. 2008 Nov;Suppl:6-8.

As members of the Rapid Response Team, pharmacists set appropriate dosing levels, make medications available, and determine if medications contributed to patient deterioration. This article explores an emerging model being tested by hospitals participating in IHI's 5 Million Lives Campaign.

Berwick DM. Taming the technology beast. Journal of the American Medical Association. 2008 June 25;299(24):2898-2899.

This editorial comments on the report by van der Togt and colleagues on electromagnetic interference (EMI) from radiofrequency identification (RFID) technologies affecting other medical equipment in intensive care units such as infusion pumps, external pacemakers, and mechanical ventilators. The investigators found 22 of 34 EMI incidents were hazardous. Berwick points out that another important lesson of the study is that physicians and other health care decision makers should tame technology, not avoid it. [Read a related interview with Don Berwick in Materials Management in Health Care.]

Wood DA. Texas hospitals reduce VAP. Nurse.com; June 16, 2008.

Not that long ago, nurses considered ventilator-associated pneumonia (VAP) an accepted risk for critically ill patients requiring mechanical respiratory support, but no more. Nurses have learned that their consistent efforts can decrease the risk of the potentially lethal, nosocomial infection.

Ovretveit J, Suffoletto JA. Improving rapid response systems: Progress, issues, and future directions. Joint Commission Journal on Quality and Patient Safety. 2007 Aug;33(8):512-519.

"Detect the emergency and respond to it right at the patient's bedside" sums up the focus of the May 2007 Third International Conference on Rapid Response Systems. This article provides a synopsis of sessions presented at the conference, describes types of response teams and systems, and analyzes benefits and barriers.

Kaushal R, Bates DW, Franz C, Soukup JR, Rothschild JM. Costs of adverse events in intensive care units. Critical Care Medicine. Nov 2007;35(11):2479-2483.

Iatrogenic injuries are very common in critically ill adults. However, the financial implications of these events are incompletely understood. This article describes a study to determine the costs of adverse events in patients in the medical intensive care unit and in the cardiac intensive care unit.