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J Korean Med Sci. 2014 Mar;29(3):423-30. doi: 10.3346/jkms.2014.29.3.423. Epub 2014 Feb 27.

The extended rapid response system: 1-year experience in a university hospital.

Author information

1
Division of Pulmonary and Critical Care Medicine, Hanyang University Hospital, Seoul, Korea. ; Hanyang Rapid Response Team (HaRRT), Hanyang University Hospital, Seoul, Korea.
2
Hanyang Rapid Response Team (HaRRT), Hanyang University Hospital, Seoul, Korea.
3
Division of Pulmonary and Critical Care Medicine, Hanyang University Hospital, Seoul, Korea.
4
Division of Nephrology and Department of Quality Improvement, Hanyang University Hospital, Seoul, Korea.
5
The Hospital President Office of Hanyang University Hospital, Seoul, Korea.
6
The Chief Executive Office of Hanyang University Medical Center, Seoul, Korea.
7
Hanyang Rapid Response Team (HaRRT), Hanyang University Hospital, Seoul, Korea. ; Division of Cardiology, Hanyang University Hospital, Seoul, Korea.

Abstract

The rapid response system (RRS) is an innovative system designed for in-hospital, at-risk patients but underutilization of the RRS generally results in unexpected cardiopulmonary arrests. We implemented an extended RRS (E-RRS) that was triggered by actively screening at-risk patients prior to calls from primary medical attendants. These patients were identified from laboratory data, emergency consults, and step-down units. A four-member rapid response team was assembled that included an ICU staff, and the team visited the patients more than twice per day for evaluation, triage, and treatment of the patients with evidence of acute physiological decline. The goal was to provide this treatment before the team received a call from the patient's primary physician. We sought to describe the effectiveness of the E-RRS at preventing sudden and unexpected arrests and in-hospital mortality. Over the 1-yr intervention period, 2,722 patients were screened by the E-RRS program from 28,661 admissions. There were a total of 1,996 E-RRS activations of simple consultations for invasive procedures. After E-RRS implementation, the mean hospital code rate decreased by 31.1% and the mean in-hospital mortality rate was reduced by 15.3%. In conclusion, the implementation of E-RRS is associated with a reduction in the in-hospital code and mortality rates.

KEYWORDS:

At-Risk Patient; Death, Sudden, Cardiac; Extended RRS; Implementation; Mortality; Rapid Response System

PMID:
24616594
PMCID:
PMC3945140
DOI:
10.3346/jkms.2014.29.3.423
[Indexed for MEDLINE]
Free PMC Article

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