Rapid Response Systems: A Mandatory System of Care or an Optional Extra for Bedside Clinical Staff?

Buist, Michael; Shearer, William

doi:10.1016/s1553-7250(10)36041-7

Cited by 7 publications

(6 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, there may be problems around staff competency or cultural issues around staff losing face by calling for help. As a result, rather than trying to understand or deal with this very real issue of face validity, possible competency issues and probable cultural issues, the administrative response, all too often, is just to alter the policy and procedure and make the activation criteria mandatory for the bedside staff [68].…”

Section: Cfc and The Traditional Hierarchical Referral Model Of Carementioning

confidence: 99%

Adverse Events in Hospitals: “Swiss Cheese” Versus the “Hierarchal Referral Model of Care and Clinical Futile Cycles”

Buist¹

2018

Vignettes in Patient Safety - Volume 3

View full text Add to dashboard Cite

The James Reason 'Swiss Cheese' model of adverse event causation has been the predominant principle in the determination and prevention of health-care-associated adverse events for the last 20 years. This model was developed to understand the causation of large-scale organisational and industrial accidents. In principle, it looks for holes in the defence layers of a large organisation that are largely administrative and not the fault of individuals that may be directly involved with the accident. This model has limitations when applied to health care, where most of the errors or accidents are individual technical or competency deficiencies within a background of an ever-changing micro socio-cultural environment. As such, using 'Swiss Cheese' methodology, there has been an over reliance on looking for system issues in health care that has led to a decreased focus on the individual performance of the health-care professional and avoidance of difficult cultural workplace issues. Clinical futile cycles (CFCs) are a model of adverse event causation that primarily focuses on the interaction between the immediate healthcare professionals and patients and between health-care professionals. This focus allows for interventions that address issues such as clinical competency and the culture of the health-care environment.

show abstract

Section: Cfc and The Traditional Hierarchical Referral Model Of Carementioning

confidence: 99%

Adverse Events in Hospitals: “Swiss Cheese” Versus the “Hierarchal Referral Model of Care and Clinical Futile Cycles”

Buist¹

2018

Vignettes in Patient Safety - Volume 3

View full text Add to dashboard Cite

show abstract

“…[1][2][3] The intent of Rapid Response Systems (RRSs) to focus attention on patients in decline seems sound, but in practice, their effectiveness in improving outcomes has been questioned. [2][3][4][5][6][7][8] The criteria for a rapid response activation (RRA) are based largely on quantifiable threshold vital sign abnormalities (TVSAs), including respiratory rate, heart rate, blood pressure, oxygen saturation, and temperature. Patients typically display evidence of deterioration via vital signs for 6 to 8 hours prior to an adverse event, such as a cardiopulmonary arrest.…”

mentioning

confidence: 99%

“…Patients typically display evidence of deterioration via vital signs for 6 to 8 hours prior to an adverse event, such as a cardiopulmonary arrest. [7][8][9][10][11][12][13][14][15] With the advent of electronic vital sign collection and data warehousing, it has become possible to look at each vital sign for every patient through their entire hospital stay in order to characterize the frequency of TVSAs in hospitalized patients as well as the relationship of such vital signs to adverse outcomes.The First Consensus Conference on Medical Emergency Teams describes such systems as having an afferent limb (or a triggering mechanism), an efferent limb (or a response team), an improvement limb, and an administrative limb.The composition of the team itself, be it a MET or RRT, varies from hospital to hospital. Teams are led by a physician or a nurse and are designed to resolve "the mismatch between the patient's needs and the immediately available resources."…”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Vital Sign Abnormalities, Rapid Response, and Adverse Outcomes in Hospitalized Patients

et al. 2012

View full text Add to dashboard Cite

Rapid response activation (RRA), triggered chiefly by surpassing threshold vital sign abnormalities (TVSAs), is designed to intervene at the earliest point in a patient's deteriorating course. The authors aimed to quantify the incidence of TVSA among patients hospitalized on acute care units in a hospital that uses rapid response. During the course of 6 months, the authors compared adverse events (mortality, unexpected intensive care unit [ICU] transfers, and cardiopulmonary arrest) and TVSA among patients who triggered an RRA, patients with TVSAs and no RRA, and all other patients. At least 1 TVSA was recorded in 31.9% of stays and 12.2% of patient-days. RRA patients were more likely (22.5%) than other TVSA patients (7.9%) and other patients (1.8%) to have an adverse event (P < .01). Incidence varied by vital sign. During the investigation, only 2.5% of TVSA opportunities triggered an RRA. As systems engage electronic workflows, automatically triggering RRAs based solely on TVSAs could place a tremendous burden on systems.

show abstract

“…Geoffrey K. Lighthall, MD Stanford University Palo Alto, CA T he high frequency of occurrence and adverse outcomes of sepsis-associated acute kidney injury demand a better understanding of the pathophysiology of this disorder (1,2). The past three decades have witnessed intense efforts to delineate the regulatory role of nitric oxide (NO) in health and disease.…”

mentioning

confidence: 99%

Generation of early warnings with smart monitors

Lighthall¹

2012

Critical Care Medicine

View full text Add to dashboard Cite

Rapid Response Systems: A Mandatory System of Care or an Optional Extra for Bedside Clinical Staff?

Cited by 7 publications

References 34 publications

Adverse Events in Hospitals: “Swiss Cheese” Versus the “Hierarchal Referral Model of Care and Clinical Futile Cycles”

Adverse Events in Hospitals: “Swiss Cheese” Versus the “Hierarchal Referral Model of Care and Clinical Futile Cycles”

Vital Sign Abnormalities, Rapid Response, and Adverse Outcomes in Hospitalized Patients

Generation of early warnings with smart monitors

Contact Info

Product

Resources

About