Strategies for successful implementation and permanent maintenance of a rapid response system
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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.
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.
참고문헌 (39)
- Bedell SE, "Incidence and characteristics of preventable iatrogenic cardiac arrests", JAMA, 265, pp.2815~2820 (1991)
- Andersen LW, "The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest", Resuscitation, 98, pp.112~117 (2016)
- Berwick DM, "The 100, 000 lives campaign : setting a goal and a deadline for improving health care quality", JAMA, 295, pp.324~327 (2006)
- DeVita MA, "Use of medical emergency team responses to reduce hospital cardiopulmonary arrests", Qual Saf Health Care, 13, pp.251~254 (2004)
- Buist M, "Six year audit of cardiac arrests and medical emergency team calls in an Australian outer metropolitan teaching hospital", BMJ, 335, pp.1210~1212 (2007)
- Dacey MJ, "The effect of a rapid response team on major clinical outcome measures in a community hospital", Crit Care Med, 35, pp.2076~2082 (2007)
- Offner PJ, "Implementation of a rapid response team decreases cardiac arrest outside of the intensive care unit", J Trauma, 62, pp.1223~1228 (2007)
- Sharek PJ, "Effect of a rapid response team on hospital-wide mortality and code rates outside the ICU in a children’s hospital", JAMA, 298, pp.2267~2274 (2007)
- Hillman K, "Introduction of the medical emergency team(MET)system : a cluster-randomised controlled trial", Lancet, 365, pp.2091~2097 (2005)
- Jones DA, "Rapid-response teams", N Engl J Med, 365, pp.139~146 (2011)
- Subbe CP, "Validation of a modified Early Warning Score in medical admissions", QJM, 94, pp.521~526 (2001)
- Smith GB, "A comparison of the ability of the physiologic components of medical emergency team criteria and the U.K. National Early Warning Score to discriminate patients at risk of a range of adverse clinical outcomes", Crit Care Med, 44, pp.2171~2181 (2016)
- Jarvis S, "Aggregate National Early Warning Score(NEWS)values are more important than high scores for a single vital signs parameter for discriminating the risk of adverse outcomes", Resuscitation, 87, pp.75~80 (2015)
- Romero-Brufau S, "Widely used track and trigger scores: are they ready for automation in practice?", Resuscitation, 85, pp.549~552 (2014)
- Smith GB, "Review and performance evaluation of aggregate weighted ‘track and trigger’ systems", Resuscitation, 77, pp.170~179 (2008)
- Smith GB, "A review, and performance evaluation, of single-parameter"track and trigger"systems", Resuscitation, 79, pp.11~21 (2008)
- Boniatti MM, "Delayed medical emergency team calls and associated outcomes", Crit Care Med, 42, pp.26~30 (2014)
- Shearer B, "What stops hospital clinical staff from following protocols? : an analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus Australian metropolitan healthcare service", BMJ Qual Saf, 21, pp.569~575 (2012)
- Churpek MM, "Multicenter comparison of machine learning methods and conventional regression for predicting clinical deterioration on the wards", Crit Care Med, 44, pp.368~374 (2016)
- Kwon JM, "An algorithm based on deep learning for predicting in-hospital cardiac arrest", J Am Heart Assoc, 7, pp.e008678~ (2018)
- Cho KJ, "Detecting patient deterioration using artificial intelligence in a rapid response system", Crit Care Med, 48, pp.e285~e289 (2020)
- LeCun Y, "Deep learning", Nature, 521, pp.436~444 (2015)
- Subbe CP, "Quality metrics for the evaluation of rapid response systems:proceedings from the third international consensus conference on Rapid Response Systems", Resuscitation, 141, pp.1~12 (2019)
- Gill FJ, "The impact of implementation of family-initiated escalation of care for the deteriorating patient in hospital : a systematic review", Worldviews Evid Based Nurs, 13, pp.303~313 (2016)
- Vorwerk J, "Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems : a literature review", J Clin Nurs, 25, pp.38~52 (2016)
- Albutt AK, "Is there a role for patients and their relatives in escalating clinical deterioration in hospital? : a systematic review", Health Expect, 20, pp.818~825 (2017)
- Mitchell OJL, "Characterising variation in composition and activation criteria of rapid response and cardiac arrest teams : a survey of Medicare participating hospitals in five American states", BMJ Open, 9, pp.e024548~ (2019)
- See MT, "Effectiveness of a patient education intervention in enhancing the self-efficacy of hospitalized patients to recognize and report acute deteriorating conditions", Patient Educ Couns, 97, pp.122~127 (2014)
- Jones D, "Effectiveness of the medical emergency team : the importance of dose", Crit Care, 13, pp.313~ (2009)
- Olsen SL, "Succeeding with rapid response systems : a never-ending process : a systematic review of how health-care professionals perceive facilitators and barriers within the limbs of the RRS", Resuscitation, 144, pp.75~90 (2019)
- Kim HJ, "Performance of patient acuity rating by rapid response team nurses for predicting short-term prognosis", PLoS One, 14, pp.e0225229~ (2019)
- Edelson DP, "Patient acuity rating : quantifying clinical judgment regarding inpatient stability", J Hosp Med, 6, pp.475~479 (2011)
- Karvellas CJ, "Association between implementation of an intensivist-led medical emergency team and mortality", BMJ Qual Saf, 21, pp.152~159 (2012)
- Morris DS, "Differences in outcomes between ICU attending and senior resident physician led medical emergency team responses", Resuscitation, 83, pp.1434~1437 (2012)
- Dukes K, "Assessment of rapid response teams at top-performing hospitals for in-hospital cardiac arrest", JAMA Intern Med, 179, pp.1398~1405 (2019)
- Bagshaw SM, "A survey of nurses’ beliefs about the medical emergency team system in a Canadian tertiary hospital", Am J Crit Care, 19, pp.74~83 (2010)
- Butcher BW, "The effect of a rapid response team on resident perceptions of education and autonomy", J Hosp Med, 10, pp.8~12 (2015)
- "Guidance on rapid response system polor project" (2019)[URL]
- Joint College of Intensive Care Medicine and Australian and New Zealand Intensive Care Society Special Interest Group on Rapid Response Systems, "Resource use, governance and case load of rapid response teams in Australia and New Zealand in 2014", Crit Care Resusc, 18, pp.275~282 (2016)
