Simulation Training Using Postoperative SAEs (Serious Adverse Events) Cases Is a Good Teaching Method for RRS (Rapid Response System)

Objective To assess the impact of a regional rapid response system (RRS) implemented in a Chinese Joint Commission International Hospital on the timely treatment of patients with serious adverse events (SAEs). Methods Clinical SAEs, activation periods, reasons for RSS activation, and patient outcomes were assessed using SAE response sheets at admission to the hospital and over 31 months of follow-up. Results We found that 192 events were called by medical staff and 6 were called by auxiliary staff. Reasons for the 385 RRS activations included: unconsciousness (133; 34.5%), and airway obstruction and absent carotid pulse (49 each; 12.7%). The average arrival time of the medical emergency team was 2.4 ± 0.1 minutes. There were 123 (62.1%) RRS activations during daytime working hours (8:00–17:00); CPR was performed in 86 (43.4%) cases. Outcomes of RRS were: vital signs stabilized in 82 (41.4%) patients and 61 (30.8%) patients were transferred to ICU. Conclusion Our experience showed that the regional RRS has led to better integrated multidisciplinary cooperation and reduced time for treating patients with SAEs, resulting in success of the RRS.

Download Full-text

The effectiveness of a standardised rapid response system on the reduction of cardiopulmonary arrests and other adverse events among emergency surgical admissions

Resuscitation ◽

10.1016/j.resuscitation.2020.01.021 ◽

2020 ◽

Vol 150 ◽

pp. 162-169 ◽

Cited By ~ 2

Author(s):

Lixin Ou ◽

Jack Chen ◽

Ken Hillman ◽

Arthas Flabouris ◽

Michael Parr ◽

...

Keyword(s):

Adverse Events ◽

Rapid Response ◽

Rapid Response System ◽

Response System

Download Full-text

The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis

Journal of Anesthesia ◽

10.1007/s00540-021-02900-4 ◽

2021 ◽

Author(s):

Yoshiki Sento ◽

◽

Masayasu Arai ◽

Yuji Yamamori ◽

Shinsuke Fujiwara ◽

...

Keyword(s):

Postoperative Management ◽

Rapid Response ◽

Rapid Response System ◽

Low Oxygen ◽

Hospital Emergency ◽

Database Analysis ◽

Fluid Bolus ◽

Serious Adverse Events ◽

Response System ◽

General Wards

Abstract Purpose Improving the safety of general wards is a key to reducing serious adverse events in the postoperative period. We investigated the characteristics, treatment, and outcomes of postoperative patients managed by a rapid response system (RRS) in Japan to improve postoperative management. Methods This retrospective study analyzed cases requiring RRS intervention that were included in the In-Hospital Emergency Registry in Japan. We analyzed data reported by 34 Japanese hospitals between January 2014 and March 2018, mainly focusing on postoperative patients for whom the RRS was activated within 7 days of surgery. Non-postoperative patients, for whom the RRS was activated in all other settings, were used for comparison as necessary. Results There were 609 (12.7%) postoperative patients among the total patients in the registry. The major criteria were staff concerns (30.2%) and low oxygen saturation (29.7%). Hypotension, tachycardia, and inability to contact physicians were observed as triggers significantly more frequently in postoperative patients when compared with non-postoperative patients. Among RRS activations within 7 days of surgery, 68.9% of activations occurred within postoperative day 3. The ordering of tests (46.8%) and fluid bolus (34.6%) were major interventions that were performed significantly more frequently in postoperative patients when compared with non-postoperative patients. The rate of RRS activations resulting in ICU care was 32.8%. The mortality rate at 1 month was 16.2%. Conclusion Approximately, 70% of the RRS activations occurred within postoperative day 3. Circulatory problems were a more frequent cause of RRS activation in the postoperative group than in the non-postoperative group.

Download Full-text