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Qual Saf Health Care 18:500-504 doi:10.1136/qshc.2007.026054
  • Error management

A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric rapid response system

  1. C C Hanson1,
  2. G D Randolph1,
  3. J A Erickson1,
  4. C M Mayer2,
  5. J T Bruckel2,
  6. B D Harris1,
  7. T S Willis1
  1. 1
    Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
  2. 2
    Department of Performance Improvement and Patient Safety, UNC Hospitals, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Tina Schade Willis, Pediatric Critical Care Medicine, University of North Carolina, 214 MacNider Building, Chapel Hill, NC 27599-7221, USA; twillis{at}unch.unc.edu
  • Accepted 22 October 2008

Abstract

Objective: To determine the effects of a multifaceted paediatric rapid response system on the duration of predefined clinical instability and the subsequent rate of cardiac arrests.

Methods: An interrupted time series study coupled with a retrospective chart review to evaluate the effects of implementing a four component paediatric rapid response system. All patients in a 136-bed university-affiliated paediatric hospital from August 2003 to May 2007 were considered. The main outcome measures included rate of cardiac arrests as indicated by the number of patient days between ward paediatric cardiac arrests and duration of predefined clinical instability before evaluation by critical care personnel.

Results: The mean time interval between cardiac arrests increased significantly with the establishment of the rapid response system from a baseline of 2512 to 9418 patient days. The median duration of clinical instability decreased from 9 h 55 min to 4 h 15 min post intervention (p = 0.028).

Conclusions: The implementation of a paediatric rapid response system is associated with a significant reduction in the rate of cardiac arrests and duration of clinical instability before evaluation by critical care personnel. This study provides evidence that implementation of a rapid response system brings emergency personnel to deteriorating patients earlier, thus preventing cardiac arrests.

Footnotes

  • Competing interests None.

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