Failure to rescue: using rapid response systems to improve care of the deteriorating patient in hospital

Abstract

“Failure to rescue” is the inadequate or delayed response to clinical deterioration in hospitalized patients. Rapid response systems are a set of hospital-wide interventions that attempt to reduce failure to rescue by improving patient monitoring on general wards (the afferent component) and the reliability of the response to deterioration by a dedicated Critical Care Outreach Team, Rapid Response Team or Medical Emergency Team (the efferent component). The reliability of such systems depends on the faultless functioning of a “chain of survival” consisting of: (1) high-quality recording of vital signs; (2) the education and mind-set of staff at the bedside to recognize pathological patterns; (3) the reporting of abnormality to the efferent team; (4) a timely and appropriate response by the latter. Repeated feedback loops are crucial for an effective functioning of the chain.