Stahel P F, Fakler J K M, Flierl M A, Moldenhauer K, Mehler P S
Department of Orthopaedic Surgery and Department of Neurosurgery, Denver Health Medical Center, University of Colorado, School of Medicine, 777 Bannock Street, 80204, Denver, CO, USA.
Unfallchirurg. 2010 Mar;113(3):239-46. doi: 10.1007/s00113-009-1734-7.
The "100,000 lives campaign" initiated a wide-spread implementation of rapid response teams in the United States. A standardized rapid response system (RRS) is designed to reduce the preventable mortality of hospitalized patients who frequently have progressive signs of physiological deterioration minutes to hours before cardiac arrest. The implementation and maturation of a team-based RRS has been shown to significantly reduce the incidence of "COR zero" calls and, in some studies, the in-hospital mortality rate. An alternative model to rapid response teams has been recently proposed which is based on defined clinical triggers to initiate a "rapid response escalation". This clinical triggers program overcomes the classic limitations of a team-based system, such as the overuse of resources and the fragmentation of patient care. The present review outlines the basic RRS concept with a focus on the debate related to the "perfect" patient safety system, namely the validity of a distinct rapid response teams approach versus a trigger-based escalation modality. The implementation of a standardized RRS should also be considered in German hospitals with the aim of improving patient safety and reducing preventable in-hospital mortality.
