Early recognition of warning signs of deterioration is key to activating the rapid response system (RRS) and prevention of serious adverse events. This review sought to understand how preparedness of ward-based nurses supports recognition of early warning signs and activation of RRS. Themes include knowledge of criteria to activate the RRS and deference to organizational hierarchy.

Medical emergency teams are an important system for providing emergency care for acutely deteriorating hospitalized patients. This systematic review found that medication administration errors are common during medical emergency team responses. However, a paucity of literature precluded conclusions on whether specific safety strategies (such as user-applied medication labels, which are often used in anesthesia) are effective at preventing these errors.

Patients and families have the potential to help medical teams proactively detect clinical deteriorations. This qualitative study with consumer advocates resulted in a comprehensive model for empowering patients to accurately activate rapid response systems.

Engaging patients and their families to call rapid response teams (RRTs) has been promoted as a patient safety strategy. This literature review found that consumer education programs for RRT activation led to more RRT calls by both consumers and clinicians and decreased rates of patient mortality.

Handoffs between care settings can lead to adverse events. This literature review analyzed 17 studies of handoffs between prehospital first responders and emergency department (ED) staff. Safety gaps detected included communication barriers, lack of a structured communication tool, and unclear identification of the receiving clinical staff. The authors suggest that a structured handoff tool could improve first responder–ED handoffs. A past AHRQ WebM&M commentary discussed communication failures between providers and highlighted a need for standard handoff protocols.