TY - JOUR
T1 - The impact of implementing a rapid response system
T2 - A comparison of cardiopulmonary arrests and mortality among four teaching hospitals in Australia
AU - Chen, Jack
AU - Ou, Lixin
AU - Hillman, Ken
AU - Flabouris, Arthas
AU - Bellomo, Rinaldo
AU - Hollis, Stephanie J.
AU - Assareh, Hassan
PY - 2014/9
Y1 - 2014/9
N2 - Aims: To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia. Methods: For the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010. We compared the rates of in-hospital cardiopulmonary arrest (IHCA), IHCA-related mortality, overall hospital mortality and 1-year post discharge mortality after IHCA between the RRS hospital and the non-RRS hospitals based on three separate analyses: (1) pooled analysis during 2002-2008; (2) before-after difference between 2008 and 2009; (3) after implementation in 2009. Results: During the 2002-2008 period, the mature RRS hospital had a greater than 50% lower IHCA rate, a 40% lower IHCA-related mortality, and 6% lower overall hospital mortality. Compared to 2008, in their first year of RRS (2009) two hospitals achieved a 22% reduction in IHCA rate, a 22% reduction in IHCA-related mortality and an 11% reduction in overall hospital mortality. During the same time, the mature RRS hospital showed no significant change in those outcomes but, in 2009, it still achieved a crude 20% lower IHCA rate, and a 14% lower overall hospital mortality rate. There was no significant difference in 1-year post-discharge mortality for survivors of IHCA over the study period. Conclusions: Implementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality.
AB - Aims: To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia. Methods: For the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010. We compared the rates of in-hospital cardiopulmonary arrest (IHCA), IHCA-related mortality, overall hospital mortality and 1-year post discharge mortality after IHCA between the RRS hospital and the non-RRS hospitals based on three separate analyses: (1) pooled analysis during 2002-2008; (2) before-after difference between 2008 and 2009; (3) after implementation in 2009. Results: During the 2002-2008 period, the mature RRS hospital had a greater than 50% lower IHCA rate, a 40% lower IHCA-related mortality, and 6% lower overall hospital mortality. Compared to 2008, in their first year of RRS (2009) two hospitals achieved a 22% reduction in IHCA rate, a 22% reduction in IHCA-related mortality and an 11% reduction in overall hospital mortality. During the same time, the mature RRS hospital showed no significant change in those outcomes but, in 2009, it still achieved a crude 20% lower IHCA rate, and a 14% lower overall hospital mortality rate. There was no significant difference in 1-year post-discharge mortality for survivors of IHCA over the study period. Conclusions: Implementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality.
KW - Cardiac arrests
KW - Hospital mortality
KW - Medical emergency team
KW - Rapid response systems
KW - Rapid response team
KW - Unexpected deaths
UR - http://www.scopus.com/inward/record.url?scp=84905967470&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2014.06.003
DO - 10.1016/j.resuscitation.2014.06.003
M3 - Article
C2 - 24950297
AN - SCOPUS:84905967470
SN - 0300-9572
VL - 85
SP - 1275
EP - 1281
JO - Resuscitation
JF - Resuscitation
IS - 9
ER -