Strategies for successful implementation and permanent maintenance of a rapid response system

Abstract

Rapid response systems (RRSs) have been introduced to intervene with patients experiencing non-code medical emergencies and operate widely around the world. An RRS has four components: an afferent limb, an efferent limb, quality improvement, and administration. A proper triggering system, a hospital culture that embraces the RRS from the afferent limb, experienced primary responders, and dedicated physicians from the efferent limb are key for successful implementation. After initial implementation, quality improvement through objective outcome measures and self-evaluation are crucial, which lead to a better outcome when this process is well performed. Furthermore, better outcomes lead to more investment, which is essential for effective development of the system. The RRS is successfully maintained when these four components are closely interconnected.

The development and validation of a novel deep-learning algorithm to predict in-hospital cardiac arrest in ED-ICU (emergency department-based intensive care units): a single center retrospective cohort study

“…Higher specificity was noted, with the same sensitivity as NEWS, for all cutoff scores; this means that lower alarms were produced regardless of any sensitivity cutoff. The reduction rate ranged from 20.0% to 48.0% when compared to NEWS, which overcame the inherent limitations of conventional EWSs which tend to have a high false alarm rate [33,34] and can also lead to alarm fatigue in the medical staff in charge and ultimately a desensitization to false alarms (Table 7) [35]. Attenuating alarm fatigue may rescue medical staff who are responsible for critical care from information that can be overlooked in ICUs.…”

Improvement of the rapid response system at an acute rehabilitation hospital in New Mexico

“…As seen by previous studies, having a strong efferent limb consisting of an experienced multidisciplinary team is essential to the success of an RRS [ 8 ]. We addressed this in our study by implementing rapid response training and drills with ARH clinical staff.…”

“…Song et al stated that successful RRS' requires an afferent limb with a proper triggering system, an efferent limb consisting of an experienced multidisciplinary team, and a hospital culture that embraces the RRS [ 8 ]. The afferent limb ‘triggers’ the RRTs when a patient's vital signs and laboratory values are abnormal, typically detected by a single or multi-parameter early warning system (EWS) [ 9 ].…”

Rapid Response Team Activation Triggers in Adults and Children: An Integrative Review

“…Bedside nurses, other healthcare professionals, and family members make up the afferent limb. These individuals can recognize that a patient is deteriorating and promptly activate the efferent limb, the RRT, to rescue the patient by providing appropriate care (Song & Lee, 2021). More commonly, RRT activation has been augmented with the Early Warning Score (EWS) tool.…”