Advanced practice providers versus medical residents as leaders of rapid response teams: A 12-month retrospective analysis

PLoS One. 2022 Aug 23;17(8):e0273197. doi: 10.1371/journal.pone.0273197. eCollection 2022.

Abstract

Purpose: In a time of worldwide physician shortages, the advanced practice providers (APPs) might be a good alternative for physicians as the leaders of a rapid response team. This retrospective analysis aimed to establish whether the performance of APP-led rapid response teams is comparable to the performance of rapid response teams led by a medical resident of the ICU.

Material and methods: In a retrospective single-center cohort study, the electronic medical record of a tertiary hospital was queried during a 12-months period to identify patients who had been visited by our rapid response team. Patient- and process-related outcomes of interventions of rapid response teams led by an APP were compared with those of teams led by a medical resident using various parameters, including the MAELOR tool, which measures the performance of a rapid response team.

Results: In total, 179 responses of the APP-led teams were analyzed, versus 275 responses of the teams led by a resident. Per APP, twice as many calls were handled than per resident. Interventions of teams led by APPs, and residents did not differ in number of admissions (p = 0.87), mortality (p = 0.8), early warning scores (p = 0.2) or MAELOR tool triggering (p = 0.19). Both groups scored equally on time to admission (p = 0.67) or time until any performed intervention.

Conclusion: This retrospective analysis showed that the quality of APP-led rapid response teams was similar to the quality of teams led by a resident. These findings need to be confirmed by prospective studies with balanced outcome parameters.

MeSH terms

  • Cohort Studies
  • Hospital Rapid Response Team*
  • Humans
  • Internship and Residency*
  • Prospective Studies
  • Retrospective Studies

Grants and funding

The author(s) received no specific funding for this work.