Acute Crit Care.  2019 May;34(2):108-116. 10.4266/acc.2019.00535.

Rapid response systems in Korea

• Lee BY
• Hong SB

• KMID: 2449364
• DOI: http://doi.org/10.4266/acc.2019.00535

Abstract

The inpatient treatment process is becoming more and more complicated with advanced treatments, aging of the patient population, and multiple comorbidities. During the process, patients often experience unexpected deterioration, about half of which might be preventable. Early identification of patient deterioration and the proper response are priorities in most healthcare facilities. A rapid response system (RRS) is a safety net to identify antecedents of these adverse events and to respond in a timely manner. The RRS has become an essential part of the medical system worldwide, supported by all major quality improvement organizations. An RRS consists of a trigger system and response team and needs constant assessment and process improvement. Although the effectiveness and cost-benefit of RRS remain controversial, according to previous studies, it may be beneficial by decreasing in-hospital cardiac arrest and mortality. Since the first implementation of RRS in Korea in 2008, it has been developed in over 15 medical centers and continues to expand. Recent accreditation standards and an RRS pilot program by the Korean government will promote the proliferation of RRSs in Korea.

Keyword

hospital medical emergency team; hospital rapid response team; patient safety

MeSH Terms

Accreditation
Aging
Comorbidity
Delivery of Health Care
Heart Arrest
Hospital Rapid Response Team
Humans
Inpatients
Korea*
Mortality
Patient Safety
Quality Improvement

Figure

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  Figure 1. Structure of the rapid response system. RRT: rapid response team; MET: medical emergency team; CCO: critical care outreach; EMR: electronic medical recording.

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  Figure 2. Data from Royal College of Physicians [22]. The National Early Warning Score (NEWS) scoring system. CVPU: C, new confusion; V, responds to voice; P, responds to pain; U, unresponsive.

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  Figure 3. Relationship of rapid response system team activity and cardiac arrest rates in general ward. MET dose: number of rapid response team activation except CPR per 1,000 admissions; MET: medical emergency team; CPR: cardiopulmonary resuscitation. Unpublished data from Asan Medical Center.

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  Figure 4. Types of activation of rapid response system from Korean multicenter data (n=11,646). CPCR: cardiopulmonary cerebral resuscitation; RRT: rapid response team.

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  Figure 5. Outcomes of rapid response system activation in sepsis (n=2,361). ICU: intensive care unit. Unpublished data from Asan Medical Center.

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  Figure 6. The first-attempt success rate of intubation has improved with the successful implementation of a rapid response system, in the general ward (GW) and the entire hospital. A responding team in rapid response system included experienced operator for airway management. Unpublished data from Asan Medical Center.

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