Assessment of Barriers, Perceptions, and Improvement Strategies Related to Rapid Response Team (RRT) Activation: A Comparative Study in an Oncology Setting

Rapid Response Teams (RRTs) play an important role in hospital safety systems, and they are offered to react to the initial signs of patient deterioration. Nevertheless, obstacles remain in the way of timely activation, particularly in situations related to such intricate care settings as oncology. This study aimed to take into account perceived barriers, issues, and improvement mechanisms of RRT activation in an expert oncology center.

A cross-sectional and descriptive study was conducted at Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC) in Muscat, Oman. Two questionnaires in a structured format were distributed to general hospital employees (342) and RRT members (28). The questionnaires covered deactivating issues, negative factors, and issues related to working together. Data were analyzed using descriptive statistics and the Chi-square test in order to make comparisons of perceptions in terms of gender, experience, and age. Validity and reliability were attested based on expert checking, pencil-and-paper pilot testing, and high internal consistency (Cronbach’s alpha = 0.84 in general staff and α = 0.79 in RRT).

Among general staff (n = 342), the most common barriers were unawareness of activation thresholds, 27% (n = 92); uncertainty regarding determining activation thresholds, 22% (n = 75); and lack of systematic education regarding RRT, 22% (n = 75). Female employees more frequently mentioned issues with justification (23.1% vs. 20.4%, χ² = 4.95, p = .026) and education gaps (24.1% vs. 19.0%, χ² = 5.78, p = .016). Uncertainty among staff with 0–5 years of experience was also higher (33.3%, χ² = 7.85, p = 0.020), as was difficulty in calculating early warning scores (26.7%, χ² = 8.41, p = 0.015). Inhibiting factors included dependence on the physician (14%, n = 48), team leaders (12%, n = 41), misunderstanding vital signs (11%, n = 38), and failure to compute EWS (15%, n = 51). The highest operational impediment among RRT members (n = 28) was dual ICU responsibility (34%, n = 10), which heavily affected the delivery of an effective response during activation. The general staff (highest number 15, n = 51) and team coordination by RRT members (highest number 36, n = 10) had higher counts of quality definitions than automatic availability of equipment (highest number 13, n = 4).

This paper indicated that a high proportion of staff are hesitant in activating the Rapid Response Team due to uncertainty associated with thresholds and fear of being interrogated, particularly among less experienced staff, which identifies the necessity of clear guidelines and regular training. Concurrently, there were certain barriers at a systemic level, such as incomplete handovers and dual responsibility in the ICU, which slowed responses and highlighted the necessity of enhanced team-level coordination and organizational support.

The application of RRTs in the oncology setting is undermined by knowledge gaps, role conflicts, and systemic constraints. Enhancing patient outcomes by educating staff members, flattening hierarchy, and strengthening response systems are significant strategies for improving patient outcomes.