Rapid response systems you wont know there is a problem until you measure it 英文参考文献.docVIP

Hillman Critical Care 2011,15:1001 /content/15/5/1001 COMMENTARY Rapid response systems: you won’t know there is a problem until you measure it Ken M Hillman* 1,2,3 See related research by Oglesby et al., /content/15/4/R180 bedside sta? to call when the patient has prede? ned Abstract criteria [9]. Oglesby and colleagues’ article sheds light on how di? cult it is to implement e? cient patient-centered systems. The rapid response system concept is one of the ?rst patient-centered and organizational-wide systems aimed at preventing deaths and serious adverse events. It has been strongly argued that we need a benchmark that re?ects the care of a deteriorating patient across the organization using a‘score to door time’; that is, the time from the ?rst vital sign abnormality to admission to the ICU. The study by Oglesby and colleagues highlights serious issues, especially delays, which could adversely impact on patient care, and the study proposes that we concentrate more on measuring patient care from a broad perspective. Implementing this simple patient intervention within the complexity of acute hospitals can be a challenge. A RRS operates across the usual hospital silos and can expose weakness in the global care of patients, such as variability in the level of care for the seriously ill between di? erent home teams, variability in resources necessary to recognize and respond rapidly, as well as access to intensive care beds. Oglesby and colleagues’ article describes something relatively unique – a benchmark that aims to evaluate whether a system operating across the whole hospital is e? ective. e ‘score to door time’ gives a good indication Oglesby and colleagues’ article uses the concept of a of how well the system, and all its components, are rapid response system (RRS) to identify delays in the working. For example, measurement of the vital