RT Journal Article SR Electronic T1 Patient safety on the otolaryngology service: the role of an established rapid response system JF Quality and Safety in Health Care JO Qual Saf Health Care FD BMJ Publishing Group Ltd SP 496 OP 499 DO 10.1136/qshc.2007.024810 VO 18 IS 6 A1 C L Oliver A1 M A DeVita A1 C J Dunwoody A1 J T Johnson A1 J C Sok A1 R L Simmons YR 2009 UL http://qualitysafety.bmj.com/content/18/6/496.abstract AB Objective: To study the medical emergencies occurring on a tertiary otolaryngology service identified using a rapid response system (RRS).Design: Retrospective chart review of RRS activations during 21 months.Setting: Specialised otolaryngology care unit within the University of Pittsburgh Medical Center Presbyterian/Montefiore Hospital, a tertiary, academic, teaching hospital in the USA.Intervention(s): None.Results: 1171 unit admissions. Unit mortality was 5.1/1000 admissions. 53 patients were involved in 67 RRS activations (4/53 deaths). 32 of 67 events were due to respiratory derangements, most commonly pneumonia. 18 of 67 events were due to cardiovascular abnormalities, most commonly hypertension and myocardial infarction. 11 of 67 events were secondary to mental status changes, several of which were related to adverse drug events. 6 of 67 events were secondary to acute bleeding. 23 of 67 events occurred within 24 h of patient transfer/admission, 14 of those after operations. RRS activation was a marker for in-hospital death (RR 42.2, 95% CI 7.9 to 225.2) compared with that in patients not activating the RRS.Conclusions: Although otolaryngology care units attempt to prevent adverse events, emergencies still occur. RRSs identify deteriorating otolaryngology patients who are at increased risk for mortality. RRSs are an efficient mechanism of intervention during a medical emergency. RRSs provide a convenient method of identifying medical/system errors and educational opportunities.