Rapid Response Systems

Overview

Journal Resuscitation

Specialty Emergency Medicine

Date 2018 May 20

PMID 29777740

Citations 47

Authors

Patrick G Lyons

Dana P Edelson

Matthew M Churpek

Affiliations

Soon will be listed here.

Abstract

Introduction: Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems.

Aims: We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation.

Data Sources: Articles written in English and published in PubMed.

Results: Rapid response systems are heterogeneous, with important differences among afferent and efferent arms. Clinically meaningful outcomes may include unexpected mortality, in-hospital cardiac arrest, length of stay, cost, and processes of care at end of life. Both positive and negative interventional studies have been published, although the two largest randomized trials involving rapid response systems - the Medical Early Response and Intervention Trial (MERIT) and the Effect of a Pediatric Early Warning System on All-Cause Mortality in Hospitalized Pediatric Patients (EPOCH) trial - did not find a mortality benefit with these systems, albeit with important limitations. Advances in monitoring technologies, risk assessment strategies, and behavioral ergonomics may offer opportunities for improvement.

Conclusions: Rapid responses may improve some meaningful outcomes, although these findings remain controversial. These systems may also improve care for patients at the end of life. Rapid response systems are expected to continue evolving with novel developments in monitoring technologies, risk prediction informatics, and work in human factors.

Citing Articles

Navigating Quality and Innovation: Actor-Network Theory and Hybrid Assemblages in Midwifery Practice, Implications of Maternity Early Warning Tools and Artificial Intelligence.

Ferguson B, Baldwin A, Harvey C, Henderson A Nurs Inq. 2025; 32(2):e70001.

PMID: 40025864 PMC: 11873676. DOI: 10.1111/nin.70001.

Exploring the impact of age on the predictive power of the National Early Warning score (NEWS) 2, and long-term prognosis among patients reviewed by a Rapid Response Team: A prospective, multi-centre study.

Thoren A, Andersson Franko M, Joelsson-Alm E, Rawshani A, Kahan T, Engdahl J Resusc Plus. 2025; 21():100839.

PMID: 39811470 PMC: 11732060. DOI: 10.1016/j.resplu.2024.100839.

Nurse worry as a trigger for rapid response team activation improving outcomes: a retrospective cohort study in non-critical units.

Gentil L, Nascimento M, Jaures M, de Carvalho L, Laselva C, Brandi S BMC Nurs. 2025; 24(1):42.

PMID: 39806453 PMC: 11727266. DOI: 10.1186/s12912-024-02645-x.

Hospital nurses and physicians' experiences practicing patient safety work to recognize deteriorating patients: a qualitative study.

Berg A, Werner A, Knutsen I, Johannessen A BMC Health Serv Res. 2024; 24(1):1429.

PMID: 39558336 PMC: 11575032. DOI: 10.1186/s12913-024-11908-x.

Use of a continuous single lead electrocardiogram analytic to predict patient deterioration requiring rapid response team activation.

Lee S, Benson B, Belle A, Medlin R, Jerkins D, Goss F PLOS Digit Health. 2024; 3(10):e0000465.

PMID: 39446712 PMC: 11500862. DOI: 10.1371/journal.pdig.0000465.

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