Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar 5;158(5 Pt 2):417-25.
doi: 10.7326/0003-4819-158-5-201303051-00009.

Rapid-response systems as a patient safety strategy: a systematic review

Bradford D Winters  1 , Sallie J Weaver, Elizabeth R Pfoh, Ting Yang, Julius Cuong Pham, Sydney M Dy
Affiliations

Rapid-response systems as a patient safety strategy: a systematic review

Bradford D Winters et al. Ann Intern Med. .

Abstract

Rapid-response systems (RRSs) are a popular intervention in U.S. hospitals and are supported by accreditors and quality improvement organizations. The purpose of this review is to evaluate the effectiveness and implementation of these systems in acute care settings. A literature search was performed between 1 January 2000 through 30 October 2012 using PubMed, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials. Studies published in any language evaluating outcome changes that occurred after implementing an RRS and differences between groups using and not using an RRS (effectiveness) or describing methods used by RRSs (implementation) were reviewed. A single reviewer (checked by a second reviewer) abstracted data and rated study quality and strength of evidence. Moderate-strength evidence from a high-quality meta-analysis of 18 studies and 26 lower-quality before-and-after studies published after that meta-analysis showed that RRSs are associated with reduced rates of cardiorespiratory arrest outside of the intensive care unit and reduced mortality. Eighteen studies examining facilitators of and barriers to implementation suggested that the rate of use of RRSs could be improved.

PubMed Disclaimer

Conflict of interest statement

Potential Conflicts of Interest: All other authors have no disclosures. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-2568.

Figures

Figure 1
Figure 1. Studies that reported the outcome of non–intensive care unit adult cardiorespiratory arrest
Figure 2
Figure 2. Studies that reported the outcome of total hospital adult mortality
Figure 3
Figure 3. Studies that reported the outcome of non–intensive care unit pediatric cardiorespiratory arrest
Figure 4
Figure 4. Studies that reported the outcome of total hospital pediatric mortality
See this image and copyright information in PMC

References

    1. Buist MD, Jarmolowski E, Burton PR, Bernard SA, Waxman BP, Anderson J. Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care. A pilot study in a tertiary-care hospital. Med J Aust. 1999;171:22–5. - PubMed
    1. Jones DA, DeVita MA, Bellomo R. Rapid-response teams. N Engl J Med. 2011;365:139–46. - PubMed
    1. Chan PS, Jain R, Nallmothu BK, Berg RA, Sasson C. Rapid Response Teams: A Systematic Review and Meta-analysis. Arch Intern Med. 2010;170:18–26. - PubMed
    1. Owens DK, Lohr KN, Atkins D, Treadwell JR, Reston JT, Bass EB, et al. AHRQ series paper 5: grading the strength of a body of evidence when comparing medical interventions—Agency for Healthcare Research and Quality and the Effective Health-Care Program. J Clin Epidemiol. 2010;63:513–23. - PubMed
    1. Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7:10. - PMC - PubMed

Publication types