Effectiveness and safety of an emergency department-based rapid response system
Rapid Response Systems (RRSs) are designed to assist hospitalized patients who become unstable, aiming to address “failure to rescue” and prevent cardiac arrests. Despite global implementation, evidence of RRS effectiveness is controversial. This study evaluates the effectiveness and safety of an RR...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PAGEPress Publications
2025-02-01
|
| Series: | Emergency Care Journal |
| Subjects: | |
| Online Access: | https://www.pagepressjournals.org/ecj/article/view/13374 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832540969263693824 |
|---|---|
| author | Fanny Delfanti Guido Bertolini Giovanni Nattino Giulia Acquistapace Daniela De Palma Piergiuseppe Ferrari Sara Martinenghi Stefano Maiandi Marco Rossi Anna Lilia Ruocco Maria Teresa Spina Benedetta Chiodi Stefano Paglia |
| author_facet | Fanny Delfanti Guido Bertolini Giovanni Nattino Giulia Acquistapace Daniela De Palma Piergiuseppe Ferrari Sara Martinenghi Stefano Maiandi Marco Rossi Anna Lilia Ruocco Maria Teresa Spina Benedetta Chiodi Stefano Paglia |
| author_sort | Fanny Delfanti |
| collection | DOAJ |
| description | Rapid Response Systems (RRSs) are designed to assist hospitalized patients who become unstable, aiming to address “failure to rescue” and prevent cardiac arrests. Despite global implementation, evidence of RRS effectiveness is controversial. This study evaluates the effectiveness and safety of an RRS at Maggiore Hospital in Lodi, Italy, focusing on the Medical Emergency Team (MET) organization. The RRS at Maggiore Hospital was established in 2017 using the National Early Warning Score (NEWS) for monitoring. The MET, consisting of an emergency physician and one nurse, operates from 8:00 PM to 8:00 AM. Data from 2014-2019, divided into PRE (2014-2016) and POST (2017-2019) periods, were analyzed. The primary outcomes were unplanned ICU transfers and in-hospital mortality. A difference-in-differences (DiD) design compared outcomes in MET and non-MET wards before and after RRS implementation. Hospitalizations were similar in the PRE and POST periods. A significant reduction in Intensive Care Unit (ICU) transfers was observed overall (0.26%, p=0.005), but not in mortality (0.10%, p=0.47). Both MET and non-MET wards showed reduced ICU transfers, but the decrease was statistically significant only in MET wards. DiD analysis showed no significant reductions in either ICU transfer (p=0.77) or mortality rates (p=0.15) between MET and non-MET wards. The RRS at Maggiore Hospital effectively reduced ICU transfers without increasing mortality, demonstrating its safety. The MET organization did not significantly impact ICU transfers compared to non-MET wards. Further studies should explore additional measures of clinical deterioration to fully assess the impact of RRS.
|
| format | Article |
| id | doaj-art-bf49d61fb0114c47a4a3c0f9b52b4168 |
| institution | Kabale University |
| issn | 2282-2054 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Emergency Care Journal |
| spelling | doaj-art-bf49d61fb0114c47a4a3c0f9b52b41682025-02-04T10:56:23ZengPAGEPress PublicationsEmergency Care Journal2282-20542025-02-0110.4081/ecj.2025.13374Effectiveness and safety of an emergency department-based rapid response systemFanny Delfanti0Guido Bertolini1Giovanni Nattino2Giulia Acquistapace 3Daniela De Palma4Piergiuseppe Ferrari5Sara Martinenghi6Stefano Maiandi7Marco Rossi8Anna Lilia Ruocco9Maria Teresa Spina10Benedetta Chiodi11Stefano Paglia12Emergency Unit, Ospedale di Lodi, Lodi (LO)Laboratory of Clinical Epidemiology, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica (BG)Laboratory of Clinical Epidemiology, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica (BG)Emergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Healthcare Professions Directorate – ASST di Lodi, LodiEmergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Emergency Unit, Ospedale di Lodi, Lodi (LO)Rapid Response Systems (RRSs) are designed to assist hospitalized patients who become unstable, aiming to address “failure to rescue” and prevent cardiac arrests. Despite global implementation, evidence of RRS effectiveness is controversial. This study evaluates the effectiveness and safety of an RRS at Maggiore Hospital in Lodi, Italy, focusing on the Medical Emergency Team (MET) organization. The RRS at Maggiore Hospital was established in 2017 using the National Early Warning Score (NEWS) for monitoring. The MET, consisting of an emergency physician and one nurse, operates from 8:00 PM to 8:00 AM. Data from 2014-2019, divided into PRE (2014-2016) and POST (2017-2019) periods, were analyzed. The primary outcomes were unplanned ICU transfers and in-hospital mortality. A difference-in-differences (DiD) design compared outcomes in MET and non-MET wards before and after RRS implementation. Hospitalizations were similar in the PRE and POST periods. A significant reduction in Intensive Care Unit (ICU) transfers was observed overall (0.26%, p=0.005), but not in mortality (0.10%, p=0.47). Both MET and non-MET wards showed reduced ICU transfers, but the decrease was statistically significant only in MET wards. DiD analysis showed no significant reductions in either ICU transfer (p=0.77) or mortality rates (p=0.15) between MET and non-MET wards. The RRS at Maggiore Hospital effectively reduced ICU transfers without increasing mortality, demonstrating its safety. The MET organization did not significantly impact ICU transfers compared to non-MET wards. Further studies should explore additional measures of clinical deterioration to fully assess the impact of RRS. https://www.pagepressjournals.org/ecj/article/view/13374Rapid Response System; Medical Emergency Team; Emergency Department; Emergency Medicine; Difference in Differences |
| spellingShingle | Fanny Delfanti Guido Bertolini Giovanni Nattino Giulia Acquistapace Daniela De Palma Piergiuseppe Ferrari Sara Martinenghi Stefano Maiandi Marco Rossi Anna Lilia Ruocco Maria Teresa Spina Benedetta Chiodi Stefano Paglia Effectiveness and safety of an emergency department-based rapid response system Emergency Care Journal Rapid Response System; Medical Emergency Team; Emergency Department; Emergency Medicine; Difference in Differences |
| title | Effectiveness and safety of an emergency department-based rapid response system |
| title_full | Effectiveness and safety of an emergency department-based rapid response system |
| title_fullStr | Effectiveness and safety of an emergency department-based rapid response system |
| title_full_unstemmed | Effectiveness and safety of an emergency department-based rapid response system |
| title_short | Effectiveness and safety of an emergency department-based rapid response system |
| title_sort | effectiveness and safety of an emergency department based rapid response system |
| topic | Rapid Response System; Medical Emergency Team; Emergency Department; Emergency Medicine; Difference in Differences |
| url | https://www.pagepressjournals.org/ecj/article/view/13374 |
| work_keys_str_mv | AT fannydelfanti effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT guidobertolini effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT giovanninattino effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT giuliaacquistapace effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT danieladepalma effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT piergiuseppeferrari effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT saramartinenghi effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT stefanomaiandi effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT marcorossi effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT annaliliaruocco effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT mariateresaspina effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT benedettachiodi effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem AT stefanopaglia effectivenessandsafetyofanemergencydepartmentbasedrapidresponsesystem |