Skip to main content
SpringerLink
Log in

Setting Up a Standardized Process and Outcome Assessment Tool

  • Chapter
  • First Online:
Textbook of Rapid Response Systems

  • 1686 Accesses

Abstract

Rapid response systems have evolved as a measure to improve patient safety by identifying deteriorating patients on general wards and addressing their needs at an early stage. This intervention is based on changing processes in order to change the outcomes of hospitalized patients, and evaluating the effects of such a complex system change can be challenging. In this chapter, we present the steps of implementation, data collection, and evaluation of rapid response systems

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hillman K, Parr M, Flabouris A, Bishop G, Stewart A. Redefining in-hospital resuscitation: the concept of the medical emergency team. Resuscitation. 2001;48:105–10.

    Article  CAS  PubMed  Google Scholar 

  2. Hillman K, Chen J, May E. Complex intensive care unit interventions. Crit Care Med. 2009;37:S102–6.

    Article  PubMed  Google Scholar 

  3. Bagshaw SM, Bellomo R. The need to reform our assessment of evidence from clinical trials: a commentary. Philos Ethics Humanit Med. 2008;3:23.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, Finfer S, Flabouris A. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet. 2005;365:2091–7.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  PubMed  Google Scholar 

  6. Cretikos MA, Chen J, Hillman KM, Bellomo R, Finfer SR, Flabouris A. The effectiveness of implementation of the medical emergency team (MET) system and factors associated with use during the MERIT study. Crit Care Resusc. 2007;9:206–12.

    Google Scholar 

  7. Chen J, Bellomo R, Flabouris A, Hillman K, Finfer S. The relationship between early emergency team calls and serious adverse events. Crit Care Med. 2009;37:148–53.

    Article  PubMed  Google Scholar 

  8. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ. 2002;324:387–90.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, Silvester W, Doolan L, Gutteridge G. A prospective before-and-after trial of a medical emergency team. Med J Aust. 2003;179:283–7.

    PubMed  Google Scholar 

  10. Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart G, Opdam H, Silvester W, Doolan L, Gutteridge G. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32:916–21.

    Article  PubMed  Google Scholar 

  11. Priestley G, Watson W, Rashidian A, Mozley C, Russell D, Wilson J, Cope J, Hart D, Kay D, Cowley K, Pateraki J. Introducing critical care outreach: a ward-randomised trial of phased introduction in a general hospital. Intensive Care Med. 2004;30:1398–404.

    Article  PubMed  Google Scholar 

  12. DeVita MA, Braithwaite RS, Mahidhara R, Stuart S, Foraida M, Simmons RL. Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Qual Saf Health Care. 2004;13:251–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Konrad D, Jäderling G, Bell M, Granath F, Ekbom A, Martling C. Reducing in-hospital cardiac arrests and hospital mortality by introducing a medical emergency team. Intensive Care Med. 2010;36:100–6.

    Article  PubMed  Google Scholar 

  14. Winters BD, Pham JC, Hunt EA, Guallar E, Berenholtz S, Pronovost PJ. Rapid response systems: a systematic review. Crit Care Med. 2007;35:1238–43.

    Article  PubMed  Google Scholar 

  15. Winters BD, Weaver SJ, Pfoh ER, Yang T, Pham JC, Dy SM. Rapid-response systems as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158:417–25.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bellomo R, Bagshaw SM. Evidence-based medicine: classifying the evidence from clinical trials—the need to consider other dimensions. Crit Care. 2006;10:232.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bell MB, Konrad D, Granath F, Ekbom A, Martling CR. Prevalence and sensitivity of MET-criteria in a Scandinavian University Hospital. Resuscitation. 2006;70:66–73.

    Article  PubMed  Google Scholar 

  18. Devita MA, Bellomo R, Hillman K, Kellum J, Rotondi A, Teres D, Auerbach A, Chen WJ, Duncan K, Kenward G, Bell M, Buist M, Chen J, Bion J, Kirby A, Lighthall G, Ovreveit J, Braithwaite RS, Gosbee J, Milbrandt E, Peberdy M, Savitz L, Young L, Harvey M, Galhotra S. Findings of the first consensus conference on medical emergency teams. Crit Care Med. 2006;34:2463–78.

    Article  PubMed  Google Scholar 

  19. Delaney A, Angus DC, Bellomo R, Cameron P, Cooper DJ, Finfer S, Harrison DA, Huang DT, Myburgh JA, Peake SL, Reade MC, Webb SA, Yealy DM. Bench-to-bedside review: the evaluation of complex interventions in critical care. Crit Care. 2008;12:210.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Cretikos M, Parr M, Hillman K, Bishop G, Brown D, Daffurn K, Dinh H, Francis N, Heath T, Hill G, Murphy J, Sanchez D, Santiano N, Young L. Guidelines for the uniform reporting of data for medical emergency teams. Resuscitation. 2006;68:11–25.

    Article  PubMed  Google Scholar 

  21. Peberdy MA, Cretikos M, Abella BS, De Vita M, Goldhill D, Kloeck W, Kronick SL, Morrison LJ, Nadkarni VM, Nichol G, Nolan JP, Parr M, Tibballs J, van der Jagt EW, Young L. Recommended guidelines for monitoring, reporting, and conducting research on medical emergency team, outreach, and rapid response systems: an Utstein-style scientific statement: a scientific statement from the international liaison committee on resuscitation (American Heart Association, Australian Resuscitation Council, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, and the New Zealand Resuscitation Council); the American Heart Association emergency cardiovascular care committee; the council on cardiopulmonary, perioperative, and critical care; and the interdisciplinary working group on quality of care and outcomes research. Circulation. 2007;116:2481–500.

    Article  PubMed  Google Scholar 

  22. Jones D, Baldwin I, McIntyre T, Story D, Mercer I, Miglic A, Goldsmith D, Bellomo R. Nurses’ attitudes to a medical emergency team service in a teaching hospital. Qual Saf Health Care. 2006;15:427–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Bagshaw SM, Mondor EE, Scouten C, Montgomery C, Slater-Maclean L, Jones DA, Bellomo R, Gibney RT. A survey of nurses’ beliefs about the medical emergency team system in a Canadian Tertiary Hospital. Am J Crit Care. 2009;19(1):74–83.

    Article  PubMed  Google Scholar 

  24. Hravnak M, Edwards L, Clontz A, Valenta C, Devita MA, Pinsky MR. Defining the incidence of cardiorespiratory instability in patients in step-down units using an electronic integrated monitoring system. Arch Intern Med. 2008;168:1300–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bellomo R, Ackerman M, Bailey M, Beale R, Clancy G, Danesh V, Hvarfner A, Jimenez E, Konrad D, Lecardo M, Pattee KS, Ritchie J, Sherman K, Tangkau P. A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards*. Crit Care Med. 2012;40:2349–61.

    Article  PubMed  Google Scholar 

  26. Calzavacca P, Licari E, Tee A, Egi M, Downey A, Quach J, Haase-Fielitz A, Haase M, Bellomo R. The impact of rapid response system on delayed emergency team activation patient characteristics and outcomes-a follow-up study. Resuscitation. 2009;81(1):31–5.

    Article  PubMed  Google Scholar 

  27. Quach JL, Downey AW, Haase M, Haase-Fielitz A, Jones D, Bellomo R. Characteristics and outcomes of patients receiving a medical emergency team review for respiratory distress or hypotension. J Crit Care. 2008;23:325–31.

    Article  PubMed  Google Scholar 

  28. DeVita MA, Schaefer J, Lutz J, Wang H, Dongilli T. Improving medical emergency team (MET) performance using a novel curriculum and a computerized human patient simulator. Qual Saf Health Care. 2005;14:326–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Wallin CJ, Meurling L, Hedman L, Hedegard J, Fellander-Tsai L. Target-focused medical emergency team training using a human patient simulator: effects on behaviour and attitude. Med Educ. 2007;41:173–80.

    Article  PubMed  Google Scholar 

  30. Jones D, Bellomo R, Bates S, Warrillow S, Goldsmith D, Hart G, Opdam H, Gutteridge G. Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Crit Care. 2005;9:R808–15.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Jones D, Bellomo R, DeVita MA. Effectiveness of the medical emergency team: the importance of dose. Crit Care. 2009;13:313.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Nathens AB, Jurkovich GJ, Cummings P, Rivara FP, Maier RV. The effect of organized systems of trauma care on motor vehicle crash mortality. JAMA. 2000;283:1990–4.

    Article  CAS  PubMed  Google Scholar 

  33. Jones D, Bates S, Warrillow S, Goldsmith D, Kattula A, Way M, Gutteridge G, Buckmaster J, Bellomo R. Effect of an education programme on the utilization of a medical emergency team in a teaching hospital. Intern Med J. 2006;36:231–6.

    Article  CAS  PubMed  Google Scholar 

  34. Pedersen NE, Oestergaard D, Lippert A. End points for validating early warning scores in the context of rapid response systems: a Delphi consensus study. Acta Anaesthesiol Scand. 2015;60(5):616–22.

    Article  PubMed  Google Scholar 

  35. Morris A, Owen HM, Jones K, Hartin J, Welch J, Subbe CP. Objective patient-related outcomes of rapid-response systems—a pilot study to demonstrate feasibility in two hospitals. Crit Care Resusc. 2013;15:33–9.

    PubMed  Google Scholar 

  36. Chen J, Flabouris A, Bellomo R, Hillman K, Finfer S. The medical emergency team system and not-for-resuscitation orders: results from the MERIT study. Resuscitation. 2008;79:391–7.

    Article  PubMed  Google Scholar 

  37. Jones DA, Bagshaw SM, Barrett J, Bellomo R, Bhatia G, Bucknall TK, Casamento AJ, Duke GJ, Gibney N, Hart GK, Hillman KM, Jaderling G, Parmar A, Parr MJ. The role of the medical emergency team in end-of-life care: a multicenter, prospective, observational study*. Crit Care Med. 2012;40:98–103.

    Article  PubMed  Google Scholar 

  38. Jaderling G, Bell M, Martling CR, Ekbom A, Konrad D. Limitations of medical treatment among patients attended by the rapid response team. Acta Anaesthesiol Scand. 2013;57:1268–74.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Perioperative Medicine and Intensive Care, Karolinska University Hospital, 171 76, Stockholm, Sweden

    Gabriella Jaderling MD, PhD & David Konrad MD, PhD

Authors
  1. Gabriella Jaderling MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Konrad MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gabriella Jaderling MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Critical Care, Harlem Hospital Center, New York, New York, USA

    Michael A. DeVita

  2. The Simpson Centre for Health Services Research, South Western Sydney Clinical School, UNSW Sydney, the Ingham Institute for Applied Medical Research and Intensive Care, Liverpool Hospital, Liverpool BC, New South Wales, Australia

    Ken Hillman

  3. Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia

    Rinaldo Bellomo

  4. Royal Berkshire NHS Foundation Trust, Reading, Berkshire, United Kingdom

    Mandy Odell

  5. Intensive Care Unit, Austin Hospital, Heidelberg, Victoria, Australia

    Daryl A. Jones

  6. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Bradford D. Winters

  7. Department of Anesthesia, Stanford University School of Medicine, Palo Alto, California, USA

    Geoffrey K. Lighthall

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Jaderling, G., Konrad, D. (2017). Setting Up a Standardized Process and Outcome Assessment Tool. In: DeVita, M., et al. Textbook of Rapid Response Systems. Springer, Cham. https://doi.org/10.1007/978-3-319-39391-9_35

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-39391-9_35

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39389-6

  • Online ISBN: 978-3-319-39391-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation