The article by Thomas et al, “Rapid Response Team: Challenges, Solutions, Benefits” (February 2007: 20–28), seriously misstates the financial effect of rapid response teams (RRTs). The article, which cites my work with the Veterans Health Administration (VHA) and the Institute for Healthcare Improvement (IHI), incorrectly claims savings in excess of $170000 associated with an RRT. The numbers are incorrect for the following reasons:

First, and as pointed out in my work with the VHA and others, costs cannot be reduced because they are almost entirely fixed in nature. Moving a patient from an intensive care unit (ICU) bed to the floor does not reduce the cost in the ICU unless you send ICU nurses home without pay—a strategy that no hospital can afford to implement. Nurses sent home without pay are nurses who will soon be working elsewhere!

Second, in borrowing my RRT financial benefits calculator from the IHI Web...

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