The experience of improving rapid response system performance in a Chinese Joint Commission International Hospital

To describe the institutionalization of a regional Rapid Response System (RRS) to ensure timely treatment to patients with Serious Adverse Events (SAE). We report data on RRS utilization and describe the organizational aspects, policy framework and procedures in a Chinese Joint Commission International (JCI) hospital. Between May 2013 and December 2015, a total of 198 SAEs were reported at the two hospitals; of these 109 RRS calls concerned inpatients and 89 were activated for outpatients. A total of 192 events were called by medical personnel and 6 were called by auxiliary staff in 385 calling reasons (some patients were suffer from more than one activate reasons): unconsciousness 133 (34.5%), respiratory distress 34 (8.8%), airway obstruction 49 (12.7%), fall were 31 (8.1%), carotid pulse disappear were 49 (12.7%), others were 41 (10.6%); MET average activate time was 2.4 ± 0.1 s and within 5 min; no. of RRS calls between daytime working hours (8:00-17:00) were 123 (62.1%); CPR was performed in 86 (43.4%) cases; 12 (6.1%) RRS calls were deemed to be unwarranted (false alarm): none treatment were 13 (6.6%), disposition were 3 (1.5%) and DNR was 1 (0.5%). Outcomes of RRS activation: vital signs were stabilized in 82 (41.4%) patients; death occurred in 15 (7.6%) patients, 61 (30.8%) patients were evacuated to ICU, unwilling rescue 40 (20.2%). Our experience shows that regional RRS improved rescue speed of SAEs and patient outcomes. Better integrated multidisciplinary cooperation was instrumental for the success of RRS.