J Korean Med Sci.  2014 Mar;29(3):423-430. 10.3346/jkms.2014.29.3.423.

The Extended Rapid Response System: 1-Year Experience in a University Hospital

• Kwak HJ
• Yun I
• Kim SH
• Sohn JW
• Shin DH
• Yoon HJ
• Kim GH
• Lee TY
• Park SS
• Lim YH

• KMID: 1734932
• DOI: http://doi.org/10.3346/jkms.2014.29.3.423

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.

Keyword

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

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Education, Professional
Female
Heart Arrest/mortality
*Hospital Mortality
*Hospital Rapid Response Team
Hospitals, University
Humans
Intensive Care Units
Male
Middle Aged
Young Adult

Figure

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  Fig. 1 Change in sudden arrest rates after E-RRS implementation (number of sudden arrests per 1,000 admissions). After E-RRS implementation, the mean hospital code rate decreased from 5.66 to 3.90 per 1,000 admissions and resulted in a substantial decrease in sudden death of 31.1% compared with the previous year. J-F, from January to February; M-A, from March to April; M-J, from May to June; J-A, from July to August; S-O, from September to October; N-D, from November to December. HaRRT, Hanyang Rapid Response Team

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