Rapid response system

A rapid response system (RRS) is a tool implemented in hospitals designed to identify and respond to patients with early signs of clinical deterioration on non-intensive care units with the goal of preventing respiratory or cardiac arrest. A RRS consists of two clinical components (afferent and efferent) and two organizational components (process improvement and administrative).

The afferent component, also known as the track-and-trigger system, uses standardized tools to track early signs of reversible clinical deterioration and trigger a call to the efferent component. Examples of afferent tools include single-parameter calling criteria and multi-parameter early warning scores. These tools can predict clinical deterioration based upon the patient’s trait (e.g. has epilepsy) and detect deterioration through the patient’s state (e.g. high respiratory rate). Single-parameter calling criteria require that only one criterion be met before activating the efferent component. Criteria may be based on vital signs, diagnoses, events, subjective observations, or concerns of the patient. Multi-parameter tools are more complex in that they combine several parameters into a single early warning score (EWS).

The efferent component is a multidisciplinary team trained in early resuscitation interventions and advanced life support that rushes to the deteriorating patient’s bedside to prevent respiratory and cardiac arrest in order to improve the patient’s outcomes. Often called the medical emergency team (MET), rapid response team (RRT), critical care outreach team (CCOT), or rover team, the team responds to calls placed by clinicians or families at the bedside who have detected deterioration. It may also provide proactive outreach to patients at high risk for deterioration. Composition of the teams may vary but often include one critical care attending physician or fellow, at least one nurse, and a respiratory therapist.

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