TY - JOUR T1 - Improving risk stratification and decision support for deteriorating hospital patients JF - BMJ Quality & Safety JO - BMJ Qual Saf DO - 10.1136/bmjqs-2022-015881 SP - bmjqs-2022-015881 AU - Judit Orosz AU - Daryl A Jones Y1 - 2023/02/27 UR - http://qualitysafety.bmj.com/content/early/2023/02/26/bmjqs-2022-015881.abstract N2 - In the 1990s, there was increased interest in understanding the antecedents to serious adverse events such as in-hospital cardiac arrest, unplanned admission to the intensive care unit (ICU) and in-hospital death. Studies from multiple countries around the world revealed that such adverse events were often preceded by objective signs of instability that manifested in derangements in vital signs, documentation of staff concern or increasing intensities of treatment such as oxygen therapy.1–3 In addition, staff on hospital wards did not reliably or consistently recognise clinical deterioration, nor respond in a manner that was commensurate to the requirements of the patient’s clinical needs.2–4In response to such observations, rapid response systems were developed to improve the recognition of, and response to signs of, clinical deterioration.5 6 This approach involves the use of objective criteria that trigger escalation to a predefined team of clinicians. These criteria are either single parameter or aggregated early warning scores. The responding team is variable but often comprises staff from the ICU. For example, in the UK, the team is typically a … ER -