Bavare Aarti C, Thomas Jenilea K, Elliott Elizabeth P, Morgan Angela C, Graf Jeanine M
J Healthc Qual. 2018 Mar/Apr;40(2):103-109. doi: 10.1097/JHQ.0000000000000096.
Family-initiated rapid response (FIRR) empowers families to express concern and seek care from specialized response teams. We studied FIRRs that occurred in a pediatric tertiary hospital over a 3-year period. The main aims were to describe the characteristics and outcomes of FIRRs and compare them with clinician-activated RRs (C-RRs). Of the 1,906 RRs events reviewed, 49 (2.6%) were FIRRs. All FIRRs had appropriate clinical triggers with the most common being uncontrolled pain. Chronic conditions and previous admissions were present in 61%. More than half of FIRRs had a vital sign change that should have qualified C-RR activation. Seventy-six percent FIRRs needed at least one or more interventions. Twenty-seven percent of FIRRs needed transfer to intensive care unit compared with 60% transfer rate for C-RRs.
PURPOSE OF SUBMISSION/RELEVANCE TO HEALTHCARE QUALITY: Family-initiated rapid response events were activated for legitimate concerns and frequently needed clinical interventions. Enhanced information and awareness of FIRR can improve utilization of the system and enhance family satisfaction, patient safety, and outcomes. Disseminating the information on FIRR and the importance of family involvement will improve the care of children and empower family members.
家庭发起的快速反应（FIRR）使家庭能够表达担忧并向专业反应团队寻求护理。我们研究了一家儿科三级医院在3年期间发生的FIRR。主要目的是描述FIRR的特征和结果，并将其与临床医生启动的RR（C-RR）进行比较。在审查的1906起RR事件中，49起（2.6%）为FIRR。所有FIRR都有适当的临床触发因素，最常见的是疼痛控制不佳。61%的FIRR患者患有慢性病或曾有过住院史。超过一半的FIRR有生命体征变化，这本应符合C-RR激活标准。76%的FIRR需要至少一项或多项干预措施。27%的FIRR需要转入重症监护病房，而C-RR的转入率为60%。
提交目的/与医疗质量的相关性：家庭发起的快速反应事件是出于合理担忧而启动的，并且经常需要临床干预。加强对FIRR的信息和认识可以提高系统的利用率，提高家庭满意度、患者安全性和治疗效果。传播有关FIRR的信息以及家庭参与的重要性将改善儿童护理并增强家庭成员的能力。
