Optimizing Rapid Response Team Preparedness in Ambulatory Care: An Innovative Orientation Approach

As the ambulatory care setting plays an increasingly vital role in health care, clinics are experiencing a rise in both patient volumes and acuity. For a large academic medical center with 100+ clinics spread across a large metroplex, the ambulatory care setting is essential in managing chronic disease complexities. Effective ambulatory care rapid response teams are essential to ensuring safe, high-quality care in urgent and emergent situations.
Challenges with prior orientation methods included variable engagement, staff bandwidth, and inconsistent quality of training. Addressing these issues required developing a standardized, comprehensive, and flexible orientation process utilizing the institution's learning management system. The RRT program manager and nursing professional development practitioner created an innovative online learning module including documentation procedures, policies, member expectations, standing medical orders, event reporting instructions, emergency medications, and ongoing training. Upon module completion, a designated RRT site coordinator meets with the new member to validate competencies and coordinates a mentorship with an experienced member. This blended learning approach enhances professional skills and learner satisfaction, while supporting balanced content development. This approach of combining online and in-person instruction also enhances professional skills and learner satisfaction, while supporting balanced content development. This has resulted in decreased leadership and educator burden with onboarding, while team members are able to complete the online module at their own pace. This flexibility also minimizes disruptions to their clinic duties and patient care.
Scaling a proper orientation model across multiple clinic sites has many challenges and risks falling short of its goals. A redesign of the orientation process for RRT members aims to address gaps in emergency preparedness and staff comfort to improve team effectiveness and efficiency. In 13 years, the ambulatory care RRT has grown from four buildings and 80 members to 17 buildings and a roster of over 400. The variance in patient populations, staffing models, and building designs present challenges in maintaining consistency in RRT structure and response across all locations.
A post-orientation survey showed that 98% of those onboarded felt the new method provided sufficient education on emergency response concepts, with 93% feeling confident in their ability to respond as an RRT member. Of the 298 respondents, 97% felt satisfied with the new onboarding process. Additionally, RRT members who had been onboarded before the new process were asked to complete the new onboarding process as a means of comparison. Of those surveyed, 91% felt the new onboarding process offered better preparation, with 90% preferring the module onboarding format to previous methods.
This new orientation module and pathway will continually be modified over time to best meet the evolving needs of the ambulatory rapid response teams. Ultimately, our goal is to improve staff competency, thus reducing time for emergency interventions and minimizing costly burdens on extra resources. A robust and effective onboarding fosters a more engaged and prepared team, enhancing patient care and safety in ambulatory care settings.