Rapid response teams improve outcomes: we are not sure

Wendon, Julia; Hodgson, Carol; Bellomo, Rinaldo

doi:10.1007/s00134-016-4253-3

Cited by 18 publications

(9 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some proponents have questioned the existence of the tangible benefits of the RRS and suggested the need for higher level research and randomized controlled trials while others argued that the benefits are self-evident. Several authors have also attributed the conflicting evidence regarding the effectiveness of the RRS to delay or failure in ward clinicians to activate the RRT despite patients fulfilling the activation criteria [ 24 , 27 , 29 – 32 ]. An epidemiology review of adult RRT patients in Australia revealed that close to 50% of the activations were delayed [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review

Chua

See

Legio-Quigley

et al. 2017

International Journal for Quality in Health Care

View full text Add to dashboard Cite

PurposeTo synthesize factors influencing the activation of the rapid response system (RRS) and reasons for suboptimal RRS activation by ward nurses and junior physicians.Data sourcesNine electronic databases were searched for articles published between January 1995 and January 2016 in addition to a hand-search of reference lists and relevant journals.Study selectionPublished primary studies conducted in adult general ward settings and involved the experiences and views of ward nurses and/or junior physicians in RRS activation were included.Data extractionData on design, methods and key findings were extracted and collated.Results of data synthesisThirty studies were included for the review. The process to RRS activation was influenced by the perceptions and clinical experiences of ward nurses and physicians, and facilitated by tools and technologies, including the sensitivity and specificity of the activation criteria, and monitoring technology. However, the task of enacting the RRS activations was challenged by seeking further justification, deliberating over reactions from the rapid response team and the impact of workload and staffing. Finally, adherence to the traditional model of escalation of care, support from colleagues and hospital leaders, and staff training were organizational factors that influence RRS activation.ConclusionThis review suggests that the factors influencing RRS activation originated from a combination of socio-cultural, organizational and technical aspects. Institutions that strive for improvements in the existing RRS or are considering to adopt the RRS should consider the complex interactions between people and the elements of technologies, tasks, environment and organization in healthcare settings.

show abstract

Section: Introductionmentioning

confidence: 99%

Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review

Chua

See

Legio-Quigley

et al. 2017

International Journal for Quality in Health Care

View full text Add to dashboard Cite

show abstract

“…The most common medical comorbidities were moderate to severe chronic kidney disease (defined as baseline estimated glomerular filtration rate <60 mL/min) affecting 239 (29.9%) patients, chronic pulmonary disease (219; 27.4%), ischaemic heart disease (202; 25.3%) and diabetes mellitus (193; 24.1%). The median Charlson comorbidity index (Table ) was six (IQR = 6), with 285 (35.6%) patients having a very high score (score >7), 166 (20.8%) a high score (score , ), 145 (18.1%) a medium score (score , ) and 204 (25.5%) a low score (0–3).…”

Section: Resultsmentioning

confidence: 99%

“…Such systems aim to rapidly identify clinically deteriorating patients (afferent limb) and activate appropriately trained teams (rapid response teams (RRT)) who provide resuscitative interventions (efferent limb), thereby preventing subsequent cardiac arrests and in‐hospital deaths . Whether RRS actually achieve these outcomes is still debated . Multiple studies, including several systematic reviews, report mixed results with regards to overall in‐hospital mortality …”

Section: Introductionmentioning

confidence: 99%

Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital: a prospective study

White

Scott

Bernard³

et al. 2016

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…to the EWS protocol (Jones et al, 2016;Maharaj & Stelfox, 2016;Wendon et al, 2016). Despite this, the adoption of EWSs and RRSs is widespread in acute care and recommended in the UK by the NHS (NHS England, 2017), The National Institute for Health and Clinical Excellence (NICE, 2007), NCEPOD (NCEPOD, 2015) and professional organizations (ICS/FICM, 2013, RCP, 2012.…”

mentioning

confidence: 99%

A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision‐making and referral processes

et al. 2021

View full text Add to dashboard Cite

Early warning scores (EWS) are tools designed to detect patients at risk of unexpected catastrophic deterioration in general, acute ward situations. Morgan et al. (1997) observed that many patients who were unexpectedly admitted to ICU had shown minor, premonitory disturbances of their physiology for several hours before action was taken. They suggested that early intervention on detection of these signs might improve patient outcomes and proposed a score system aggregated from ratings of vital signs that could be used to trigger intervention (Morgan et al., 1997). A wide variety of EWSs were subsequently developed (Downey, 2017. A rapid response system (RRS) comprises an EWS and a protocol for the urgent review of patients who reach a "trigger" level (Al-Qahtani & Al-Dorzi, 2010).It has proved difficult to demonstrate that any of these activities reduce morbidity and mortality in ways that can be attributed

show abstract

Rapid response teams improve outcomes: we are not sure

Cited by 18 publications

References 4 publications

Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review

Factors influencing the activation of the rapid response system for clinically deteriorating patients by frontline ward clinicians: a systematic review

Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital: a prospective study

A study to introduce National Early Warning Scores (NEWS) in care homes: Influence on decision‐making and referral processes

Contact Info

Product

Resources

About