Quality metrics for the evaluation of Rapid Response Systems: Proceedings from the third international consensus conference on Rapid Response Systems

Christian P Subbe¹, Jonathan Bannard-Smith², Jacinda Bunch³, Ratapum Champunot⁴, Michael A DeVita⁵, Lesley Durham⁶, Dana P Edelson⁷, Isabel Gonzalez⁶, Christopher Hancock⁸, Rashan Haniffa⁹, Jillian Hartin¹⁰, Helen Haskell¹¹, Helen Hogan¹², Darly A Jones¹³, Cor J Kalkman¹⁴, Geoffrey K Lighthall¹⁵, James Malycha¹⁶, Melody Z Ni¹⁷, Alison V Phillips¹⁸, Francesca Rubulotta¹⁹, Ralph K So²⁰, John Welch²¹; International Society for Rapid Response Systems

Affiliations

¹ School of Medical Sciences, Bangor University, Wales, UK. Electronic address: csubbe@hotmail.com.
² Manchester Royal Infirmary, Manchester, UK.
³ The University of Iowa, College of Nursing, USA.
⁴ Buddhachinaraj Phitsanulok Hospital, Phitsanulok, Thailand.
⁵ Harlem Hospital Center, 506 Lenox Avenue, New York, USA.
⁶ North of England Critical Care Network (NoECCN), North Tyneside General Hospital, North Shields, UK.
⁷ Department of Medicine, University of Chicago, Chicago, IL, US.
⁸ NHS Wales, Innovation House, Bridgend Road, Llanharan CF72 9RP, UK.
⁹ Network for Improving Critical Care Systems and Training, UK.
¹⁰ Patient Emergency Response and Resuscitation Team, UCLH, London, UK.
¹¹ Founder and President of the US Patient Group Mothers Against Medical Error; WHO Patient Safety Champion.
¹² London School of Hygiene & Tropical Medicine, London, UK.
¹³ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
¹⁴ UMC Utrecht, The Netherlands.
¹⁵ Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Dr. H3580, Stanford, CA, USA.
¹⁶ Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, UK.
¹⁷ Imperial College, London, UK.
¹⁸ Patient Representative, UK.
¹⁹ Anaesthesia and Intensive Care Medicine, Centre for Peri-operative Medicine and Critical Care Charing Cross Hospital Intensive Care Unit, Imperial College NHS Trust, London, UK.
²⁰ Department of Intensive Care, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands.
²¹ Consultant Nurse in Critical Care, University College London Hospital, London, UK.

PMID: 31129229
DOI: 10.1016/j.resuscitation.2019.05.012

Quality metrics for the evaluation of Rapid Response Systems: Proceedings from the third international consensus conference on Rapid Response Systems

Christian P Subbe et al. Resuscitation. 2019 Aug.

. 2019 Aug:141:1-12.

doi: 10.1016/j.resuscitation.2019.05.012. Epub 2019 May 23.

Authors

Affiliations

¹ School of Medical Sciences, Bangor University, Wales, UK. Electronic address: csubbe@hotmail.com.
² Manchester Royal Infirmary, Manchester, UK.
³ The University of Iowa, College of Nursing, USA.
⁴ Buddhachinaraj Phitsanulok Hospital, Phitsanulok, Thailand.
⁵ Harlem Hospital Center, 506 Lenox Avenue, New York, USA.
⁶ North of England Critical Care Network (NoECCN), North Tyneside General Hospital, North Shields, UK.
⁷ Department of Medicine, University of Chicago, Chicago, IL, US.
⁸ NHS Wales, Innovation House, Bridgend Road, Llanharan CF72 9RP, UK.
⁹ Network for Improving Critical Care Systems and Training, UK.
¹⁰ Patient Emergency Response and Resuscitation Team, UCLH, London, UK.
¹¹ Founder and President of the US Patient Group Mothers Against Medical Error; WHO Patient Safety Champion.
¹² London School of Hygiene & Tropical Medicine, London, UK.
¹³ Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
¹⁴ UMC Utrecht, The Netherlands.
¹⁵ Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Dr. H3580, Stanford, CA, USA.
¹⁶ Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, UK.
¹⁷ Imperial College, London, UK.
¹⁸ Patient Representative, UK.
¹⁹ Anaesthesia and Intensive Care Medicine, Centre for Peri-operative Medicine and Critical Care Charing Cross Hospital Intensive Care Unit, Imperial College NHS Trust, London, UK.
²⁰ Department of Intensive Care, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands.
²¹ Consultant Nurse in Critical Care, University College London Hospital, London, UK.

PMID: 31129229
DOI: 10.1016/j.resuscitation.2019.05.012

Erratum in

Corrigendum to "Quality metrics for the evaluation of Rapid Response Systems: Proceedings from the third international consensus conference on Rapid Response Systems" [Resuscitation 141 (2019) 1-12].
Subbe CP, Bannard-Smith J, Bunch J, Champunot R, DeVita MA, Durham L, Edelson DP, Gonzalez I, Hancock C, Haniffa R, Hartin J, Haskell H, Hogan H, Jones DA, Kalkman CJ, Lighthall GK, Malycha J, Ni MZ, Phillips AV, Rubulotta F, So RK, Welch J; International Society for Rapid Response Systems. Subbe CP, et al. Resuscitation. 2019 Dec;145:93-94. doi: 10.1016/j.resuscitation.2019.10.017. Epub 2019 Nov 16. Resuscitation. 2019. PMID: 31743828 No abstract available.

Abstract

Background: Clinically significant deterioration of patients admitted to general wards is a recognized complication of hospital care. Rapid Response Systems (RRS) aim to reduce the number of avoidable adverse events. The authors aimed to develop a core quality metric for the evaluation of RRS.

Methods: We conducted an international consensus process. Participants included patients, carers, clinicians, research scientists, and members of the International Society for Rapid Response Systems with representatives from Europe, Australia, Africa, Asia and the US. Scoping reviews of the literature identified potential metrics. We used a modified Delphi methodology to arrive at a list of candidate indicators that were reviewed for feasibility and applicability across a broad range of healthcare systems including low and middle-income countries. The writing group refined recommendations and further characterized measurement tools.

Results: Consensus emerged that core outcomes for reporting for quality improvement should include ten metrics related to structure, process and outcome for RRS with outcomes following the domains of the quadruple aim. The conference recommended that hospitals should collect data on cardiac arrests and their potential predictability, timeliness of escalation, critical care interventions and presence of written treatment goals for patients remaining on general wards. Unit level reporting should include the presence of patient activated rapid response and metrics of organizational culture. We suggest two exploratory cost metrics to underpin urgently needed research in this area.

Conclusion: A consensus process was used to develop ten metrics for better understanding the course and care of deteriorating ward patients. Others are proposed for further development.

Keywords: Cardiac arrest; Cost; Critical care; Critical care outreach; Medical emergency team; Predictable; Rapid response.

PubMed Disclaimer

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

12/178/18/DH_/Department of Health/United Kingdom

LinkOut - more resources

Full Text Sources
- Elsevier Science
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Quality metrics for the evaluation of Rapid Response Systems: Proceedings from the third international consensus conference on Rapid Response Systems

Affiliations

Quality metrics for the evaluation of Rapid Response Systems: Proceedings from the third international consensus conference on Rapid Response Systems

Authors

Affiliations

Erratum in

Abstract

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical