Failure to rescue: using rapid response systems to improve care of the deteriorating patient in hospital

Abstract

Failure to rescue" is the inadequate or delayed response to clinical deterioration in hospitalized patients. Rapid response systems are a set of hospital-wide interventions that attempt to reduce failure to rescue by improving patient monitoring on general wards (the afferent component) and the reliability of the response to deterioration by a dedicated Critical Care Outreach Team, Rapid Response Team or Medical Emergency Team (the efferent component). The reliability of such systems depends on the faultless functioning of a "chain of survival" consisting of: (1) high-quality recording of vital signs; (2) the education and mind-set of staff at the bedside to recognize pathological patterns; (3) the reporting of abnormality to the efferent team; (4) a timely and appropriate response by the latter. Repeated feedback loops are crucial for an effective functioning of the chain.

A qualitative exploration of intentional nursing round models in the emergency department setting: investigating the barriers to their use and success

“…). Issues to do with interpersonal communications between hospital staff, inadequate training, poor safety procedures have been identified as significant influences on timely response to deterioration (Subbe & Welch ).…”

“…There is now emerging evidence from the UK of inadequacies in the management of acute patients in the hospital setting with a focus on methods to improve early detection of deterioration (Mcdonnell et al 2013). Issues to do with interpersonal communications between hospital staff, inadequate training, poor safety procedures have been identified as significant influences on timely response to deterioration (Subbe & Welch 2013).…”

National Early Warning Score: A survey of registered nurses' perceptions, experiences and barriers

“…Similar indications of maladherence can also be found in numerous other studies (Hogan et al, ; Pedersen et al, ; Petersen, Rasmussen, & Rydahl‐Hansen, ). The reliability of systems like the NEWS depends on the faultless functioning of a “chain of survival,” consisting of high‐quality recording of vital signs, and the education and mindset of staff to recognise pathological patterns, report abnormalities to a higher level of expertise with a timely and appropriate response by the latter (Subbe & Welch, ).…”

Programa educativo sobre registro da pressão arterial em serviço hospitalar de emergência: um estudo de intervenção

“…Estudos descritivos ou exploratórios são utilizados para observar e documentar aspectos de uma situação, de forma a determinar a frequência dos fatos e categorizar as informações obtidas. Normalmente são conduzidos durante o estágio inicial de um processo de investigação mais amplo e usados para estabelecer fenômenos de interesse, diagnosticar situações, esclarecer a natureza de um problema e gerar informações que possam ser úteis à realização de pesquisas futuras (THEODORSON, 1969;SOUSA et al, 2007;POLIT;BECK, 2011;ZIKMUND et al, 2013 Nove artigos científicos (BRISTOW et al, 2000;WOLFF;BOURKE, 2002;SEWARD et al, 2003;MENDES et al, 2005;CALDER et al, 2010;SCHULL, MICHAEL et al, 2011;SUBBE;WELCH, 2013;CALDER et al, 2014;LECOANET et al, 2014) Parada cardiorrespiratória nas próximas 48 horas após atendimento na UPA;…”