This is an idea that sounds great in theory – if you have a roving team of skilled resuscitation professionals in your hospital assisting nurses who are concerned about their patients, you can intervene on these patients before they deteriorate, keep people from escalating into the ICU, and improve outcomes. It’s such a great idea that the entire country of Australia has been spurred into implementing these. My hospital has them, and, no doubt, many other hospitals do as well.
The problem is, they’re having a hard time demonstrating their efficacy.
A study out of Stanford last year reported that, at their VA hospital, implementation of emergency response teams (ERTs) reduced mortality. Unfortunately, on closer reading, ERTs reduced mortality on the floor, and their primary intervention was to move people to the ICU – where their mortality was no longer counted in the study. While it is rather graceless to have people coding and dying on the floor, unfortunately they did not show the outcomes they claimed.
http://www.ncbi.nlm.nih.gov/pubmed/20624835
This more recent report, from Australia, as mentioned above, is a before and after analysis of hospital-wide mortality, CPR rates, etc. with their ERTs. They likewise show benefits, with ICU admissions, CPR rates, and mortality all declining after implementation. However – and they very astutely point this out themselves – one of the most significant functions of the ERTs was to clarify code status and affirm a greater number of people as DNR or futile resuscitation. While this function, if it reduces ICU admissions, is absolutely a cost and resource savings, I don’t think it’s precisely how they wanted to justify implementation of ERTs.
There are many reasons to have ERTs, but a mortality and cost-benefit justification has not yet been well-demonstrated.