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April 22 2009

Rapid Response Team Implementation and Hospital Mortality Rates—Reply

JAMA. 2009;301(16):1658-1660. doi:10.1001/jama.2009.530

In Reply: Dr Sherner and Dr Reynolds and colleagues allude to limitations of studying outcomes at a single institution. Previous studies may not be generalizable to all hospitals. As described in our article, our hospital is a major tertiary care urban teaching hospital with a full complement of medical and surgical subspecialties. The patient population is ethnically and racially diverse and has a high level of disease acuity (high case-mix index). Our hospital may have features that minimized the potential benefit of its rapid response team, such as a possible ceiling effect on outcomes or limitations in the quality of its rapid response team implementation. However, the lack of benefit of implementation on mortality outcomes at our institution and others should raise questions about broad recommendations for their widespread dissemination.

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