Date of Doctor of Nursing Practice Project Completion

2026

Faculty Advisor

Deborah McCrea

Abstract

Purpose: This quality improvement project evaluated the impact of a Rapid Response Team (RRT)-led proactive rounding model on the early recognition of clinical deterioration and selected patient outcomes.

Background: Delays in recognizing clinical deterioration contribute to preventable adverse events, highlighting the need for proactive strategies to support early identification and timely intervention. To address this need, the project was implemented on a 36-bed intermediate care unit at a community medical center in Southeast United States.

Methodology: Guided by the Plan-Do-Study-Act framework, the project used a six-week pre-post intervention in which an Advanced Practice Provider (APP) conducted proactive rounds on patients identified using standardized clinical criteria. Primary outcome measures included RRT activations, unplanned Intensive Care Unit (ICU) transfers, and cardiorespiratory arrest events. Data were analyzed using descriptive statistics to compare pre- and post-intervention outcomes.

Results: During the implementation period, 59 patients met rounding criteria. RRT activations decreased by 21.9%, and unplanned ICU transfers decreased by 22.2%, exceeding the project goals of 15% and 10%, respectively. One cardiorespiratory arrest occurred during the intervention period compared with none at baseline.

Implications: The findings suggest that proactive RRT rounding is a feasible and sustainable quality improvement strategy in the intermediate care setting. The intervention may improve early recognition of clinical deterioration and facilitate timely clinical intervention. Continued implementation and evaluation may further inform the long-term impact of proactive RRT rounding on patient outcomes.

Keywords

proactive rounding, rapid response team, clinical deterioration, patient safety, quality improvement

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