Making Rapid Response Real

Figures ix Preface xi Acknowledgements xiii 1 Introduction The Best We Can Do? 2 Rapid Response Teams: An Innovation in Patient Care 3 The Study 7 2 Change Management and Organizational Learning 9 Organizational Change 9 Organizational Learning 12 Summary 17 3 Research Design and Methods 19 Research Sites 20 Data Collection 22 Interviews 22 Observation 25 Archival Data 25 Data Analyses 26 Categorical Analysis 26 Quantitative Content Analysis 27 Comparison of Hospital Demographics and Change 27 Categorical Analysis Revisited 28 An Initial Model 30 4 Findings 33 RRT Calls 33 Observable Changes 33 Intuition 34 Assistance 35 Political Leverage 36 Benefits 36 Faster Care: Expanding Recovery Windows 36 Job Security 37 Resistance 38 Role Change: Individual Triage? Group Intervention 38 Occupational Territory and Status 39 Organizational Learning 40 Frontline Learning 40 Administrative Learning 42 Cultural Change 43 Cultural Integration of RRTs 43 Beyond the RRT 44 Summary 44 5 Calling the RRT: Individual Adoption 47 A Model of the RRT Activation Decision Process 47 Positive and Negative Reinforcement 49 The Importance of Managing Perception 51 Negative Reinforcement Revisited 52 Summary 55 6 Social Implementation: Organizational Adoption 57 Individual Adoption to Organizational Adoption 57 The Macro-Impact of an Individual 57 RRT Activation Revisited 59 Social Implementation: Taking It to the Frontlines 61 Revisiting Instances 62 Cultivating Positives 63 De-Emphasizing Alternatives 64 Creating Events 65 Maintaining Focus 66 Remaining Consistent 67 Summary68 7 Conclusion 71 Review 72 Implications 73 Limitations 76 Next Steps 77 Final Thought 81 Bibliography 83 Index 91 About the Author 99.