Hospital rapid response team: Difference between revisions
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==Overview== | ==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."<ref>{{Cite web| title = Hospital Rapid Response Team - MeSH - NCBI| accessdate = 2017-04-04| url = https://www.ncbi.nlm.nih.gov/mesh/68057209}}</ref> | '''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."<ref name="MeSH">{{Cite web| title = Hospital Rapid Response Team - MeSH - NCBI| accessdate = 2017-04-04| url = https://www.ncbi.nlm.nih.gov/mesh/68057209}}</ref><ref name="AHRQ">{{Cite web| title = Rapid Response Systems - AHRQ Patient Safety Network| accessdate = 2017-04-04| url = https://psnet.ahrq.gov/primers/primer/4/rapid-response-systems}}</ref><ref name="IHI">{{Cite web| title = Institute for Healthcare Improvement: Rapid Response Teams| accessdate = 2017-04-04| url = http://www.ihi.org/Topics/RapidResponseTeams/Pages/default.aspx}}</ref> A '''Medical emergency team''' includes a physician.<ref name="AHRQ"/> | ||
==Structure== | ==Structure== | ||
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===Efferent limb=== | ===Efferent limb=== | ||
The presence of a physician may not improve effectiveness.<ref name="pmid26070457">{{cite journal| author=Maharaj R, Raffaele I, Wendon J| title=Rapid response systems: a systematic review and meta-analysis. | journal=Crit Care | year= 2015 | volume= 19 | issue= | pages= 254 | pmid=26070457 | doi=10.1186/s13054-015-0973-y | pmc=4489005 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26070457 }} </ref> | |||
==Effectiveness== | ==Effectiveness== | ||
The use of hospital rapid response teams | The use of hospital rapid response teams may<ref name="pmid26921184">{{cite journal| author=De Jong A, Jung B, Daurat A, Chanques G, Mahul M, Monnin M et al.| title=Effect of rapid response systems on hospital mortality: a systematic review and meta-analysis. | journal=Intensive Care Med | year= 2016 | volume= 42 | issue= 4 | pages= 615-7 | pmid=26921184 | doi=10.1007/s00134-016-4263-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26921184 }} </ref><ref name="pmid26070457">{{cite journal| author=Maharaj R, Raffaele I, Wendon J| title=Rapid response systems: a systematic review and meta-analysis. | journal=Crit Care | year= 2015 | volume= 19 | issue= | pages= 254 | pmid=26070457 | doi=10.1186/s13054-015-0973-y | pmc=4489005 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26070457 }} </ref><ref name="pmid23460099">{{cite journal| author=Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM| title=Rapid-response systems as a patient safety strategy: a systematic review. | journal=Ann Intern Med | year= 2013 | volume= 158 | issue= 5 Pt 2 | pages= 417-25 | pmid=23460099 | doi=10.7326/0003-4819-158-5-201303051-00009 | pmc=4695999 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23460099 }} </ref> or may<ref name="pmid26850330">{{cite journal| author=Maharaj R, Stelfox HT| title=Rapid response teams improve outcomes: no. | journal=Intensive Care Med | year= 2016 | volume= 42 | issue= 4 | pages= 596-8 | pmid=26850330 | doi=10.1007/s00134-016-4246-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26850330 }} </ref> not be associated with reduced mortality according to [[meta-analysis|meta-analyses]]. The only [[randomized controlled trial]] showed no benefit.<ref name="pmid15964445">{{cite journal| author=Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G et al.| title=Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. | journal=Lancet | year= 2005 | volume= 365 | issue= 9477 | pages= 2091-7 | pmid=15964445 | doi=10.1016/S0140-6736(05)66733-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15964445 }} </ref> | ||
==References== | ==References== | ||
Latest revision as of 23:28, 4 April 2017
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]
- The afferent limb identifies clinical deterioration in patients and triggers a response.
- The efferent limb "is the response, which includes both the personnel and the equipment brought to the patient."
- Patient safety and quality improvement constitute the third component, which monitors performance of the system and provides feedback.
- 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
- ↑ "Hospital Rapid Response Team - MeSH - NCBI". Retrieved 2017-04-04.
- ↑ 2.0 2.1 "Rapid Response Systems - AHRQ Patient Safety Network". Retrieved 2017-04-04.
- ↑ "Institute for Healthcare Improvement: Rapid Response Teams". Retrieved 2017-04-04.
- ↑ Jones DA, DeVita MA, Bellomo R (2011). "Rapid-response teams". N Engl J Med. 365 (2): 139–46. doi:10.1056/NEJMra0910926. PMID 21751906.
- ↑ 5.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
