Rapid response teams improve outcomes: yes

Jones, Daryl; Rubulotta, Francesca; Welch, John J.

doi:10.1007/s00134-016-4219-5

Cited by 29 publications

(27 citation statements)

References 19 publications

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“…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

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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

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“…Evidence supporting the efficacy of rapid response teams on their own has been mixed [16, 20–23]. However, the Standard covers a far wider range of organisational systems for recognising and responding clinical deterioration.…”

Section: Discussionmentioning

confidence: 99%

Recognising and responding to deteriorating patients: what difference do national standards make?

Anstey

Bhasale

Dunbar

2019

BMC Health Serv Res

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Background The Australian Commission on Safety and Quality in Health Care released a set of national standards which became a mandatory part of accreditation in 2013. Standard 9 focuses on the identification and treatment of deteriorating patients. The objective of the study was to identify changes in the characteristics and perceptions of rapid response systems (RRS) since the implementation of Standard 9. Methods Cross-sectional study of Australian hospitals. Baseline data was obtained from a pre-implementation survey in 2010 (220 hospitals). A follow-up survey was distributed in 2015 to staff involved in implementing Standard 9 in public and private hospitals (276 responses) across Australia. Results Since 2010, the proportion of hospitals with formal RRS had increased from 66 to 85. Only 7% of sites had dedicated funding to operate the RRS. 83% of respondents reported that Standard 9 had improved the recognition of, and response to, deteriorating patients in their health service, with 51% believing it had improved awareness at the executive level and 50% believing it had changed hospital culture. Conclusions Implementing a national safety and quality standard for deteriorating patients can change processes to deliver safer care, while raising the profile of safety issues. Despite limited dedicated funding and staffing, respondents reported that Standard 9 had a positive impact on the care for deteriorating patients in their hospitals. Electronic supplementary material The online version of this article (10.1186/s12913-019-4339-z) contains supplementary material, which is available to authorized users.

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“…Clinical performance measurement, in a health system intervention, involves how measures are created, how they are implemented, and the evidence of their potential benefits and harms [17]. The RRS aims to reduce SAEs including cardiac arrest, unplanned admissions to the ICU, and death [8, 9]; however, the effectiveness of RRSs in improving patient outcomes remains controversial [18–20]. Regardless, evidence from recent meta-analyses [21–23] has suggested that implementation of RRSs has substantially reduced non-ICU cardiac arrests, hospital mortality, and unexpected mortality in the adult population without an evident effect on ICU admission rates.…”

Section: Introductionmentioning

confidence: 99%

Performance of the Afferent Limb of Rapid Response Systems in Managing Deteriorating Patients: A Systematic Review

Difonzo

2019

Critical Care Research and Practice

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Introduction The clinical components of the rapid response system (RRS) are the afferent limb, to ensure identification of in-hospital patients who deteriorate and activation of a response, and the efferent limb, to provide the response. This review aims to evaluate the factors that influence the performance of the afferent limb in managing deteriorating ward patients and their effects on patient outcomes. Methods A systematic review was performed for the years 1995–2017 by employing five electronic databases. Articles were included assessing the ability of the ward staffs to monitor, recognize, and escalate care to patient deterioration. The findings were summarized using a narrative approach. Results Thirty-one studies met the inclusion criteria. The analysis revealed major themes enclosing several factors affecting management of patients having sudden deterioration. The monitoring and recognition process was conditioned by the lack of recording of physiological parameters, the influence of facilitators, including staff education and training, and barriers, including human and environmental factors, and poor compliance with the calling criteria. The escalation of care process highlighted the influence of cultural barriers and personal judgment on RRS activation. Mainly, delayed team calls were factors strongly associated with the increased risk of unplanned admissions to the intensive care unit and length of stay, hospital length of stay and mortality, and 30-day mortality. Conclusions A combination of factors affects the timely identification and response to sudden deterioration by general ward staffs, leading to suboptimal care of patients, delayed or failed activation of RRS teams, and increased risks of worsening outcomes. The research efforts and clinical involvement to improve the governance of the factors limiting the performance of the afferent limb may ensure proper management of hospitalized patients showing physiological deterioration.

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Rapid response teams improve outcomes: yes

Cited by 29 publications

References 19 publications

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

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

Recognising and responding to deteriorating patients: what difference do national standards make?

Performance of the Afferent Limb of Rapid Response Systems in Managing Deteriorating Patients: A Systematic Review

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