Hospital rapid response team

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Overview

Hospital rapid response teams are "multidisciplinary team most frequently consisting of intensive care unit trained personnel who are available 24 hours per day, 7 days per week for evaluation of patients who develop signs or symptoms of severe clinical deterioration."[1][2][3] A Medical emergency team includes a physician.[2]

Structure

Hospital rapid response teams have four components:[4]

  1. The afferent limb identifies clinical deterioration in patients and triggers a response.
  2. The efferent limb "is the response, which includes both the personnel and the equipment brought to the patient."
  3. Patient safety and quality improvement constitute the third component, which monitors performance of the system and provides feedback.
  4. Administration and governance

Afferent limb

Efferent limb

The presence of a physician may not improve effectiveness.[5]

Effectiveness

The use of hospital rapid response teams may[6][5][7] or may[8] not be associated with reduced mortality according to meta-analyses. The only randomized controlled trial showed no benefit.[9]

References

  1. "Hospital Rapid Response Team - MeSH - NCBI". Retrieved 2017-04-04.
  2. 2.0 2.1 "Rapid Response Systems - AHRQ Patient Safety Network". Retrieved 2017-04-04.
  3. "Institute for Healthcare Improvement: Rapid Response Teams". Retrieved 2017-04-04.
  4. Jones DA, DeVita MA, Bellomo R (2011). "Rapid-response teams". N Engl J Med. 365 (2): 139–46. doi:10.1056/NEJMra0910926. PMID 21751906.
  5. 5.0 5.1 Maharaj R, Raffaele I, Wendon J (2015). "Rapid response systems: a systematic review and meta-analysis". Crit Care. 19: 254. doi:10.1186/s13054-015-0973-y. PMC 4489005. PMID 26070457.
  6. De Jong A, Jung B, Daurat A, Chanques G, Mahul M, Monnin M; et al. (2016). "Effect of rapid response systems on hospital mortality: a systematic review and meta-analysis". Intensive Care Med. 42 (4): 615–7. doi:10.1007/s00134-016-4263-1. PMID 26921184.
  7. Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM (2013). "Rapid-response systems as a patient safety strategy: a systematic review". Ann Intern Med. 158 (5 Pt 2): 417–25. doi:10.7326/0003-4819-158-5-201303051-00009. PMC 4695999. PMID 23460099.
  8. Maharaj R, Stelfox HT (2016). "Rapid response teams improve outcomes: no". Intensive Care Med. 42 (4): 596–8. doi:10.1007/s00134-016-4246-2. PMID 26850330.
  9. Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G; et al. (2005). "Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial". Lancet. 365 (9477): 2091–7. doi:10.1016/S0140-6736(05)66733-5. PMID 15964445.




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