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The PSNet Collection: All Content

The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.

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Displaying 1 - 11 of 11 Results
Thiele L, Flabouris A, Thompson C. PLoS ONE. 2022;17:e0269921.
Patient and family engagement is essential for safe healthcare. This single-site study found that while most clinicians perceived that patients and families are able to recognize clinical deterioration, clinicians expressed less favorable perceptions towards escalation processes when patients or families have concerns about clinical deterioration.
Chen J, Ou L, Hillman KM, et al. Med J Aust. 2014;201:167-70.
Although rapid response teams have been widely advocated, the evidence for their benefit remains mixed. This observational study sought to analyze the incidence of inpatient cardiopulmonary arrest and related mortality while rapid response teams were being implemented in Australia. Between 2002 and 2009, the mortality associated with inpatient cardiopulmonary arrests decreased over time. The authors found that most of the decline was due to decreased incidence of arrest, not increased survival following arrest. This finding suggests that rapid response did not play a significant role in reducing mortality from in-hospital arrest in this population, consistent with prior studies.
Chen J, Bellomo R, Flabouris A, et al. Crit Care Med. 2009;37:148-53.
The largest study of rapid response systems to date, the MERIT trial was conducted in 23 Australian hospitals and did not demonstrate overall improvement in clinical outcomes. However, a limitation of this study was that the rapid response team was not actually called to evaluate the majority of patients who subsequently suffered a cardiac arrest. This retrospective analysis of data from the same study found evidence for a "dose-response" relationship between rapid response team use and clinical outcomes, in that early activation of the team was associated with a reduction in cardiac arrests.
Chen J, Flabouris A, Bellomo R, et al. Resuscitation. 2008;79:391-7.
Rapid response systems (RRS, sometimes also termed medical emergency teams) are designed to intervene promptly on inpatients whose clinical condition is acutely deteriorating. Early RRS studies also demonstrated an additional role: evaluating the goals of care and potentially instituting "do-not resuscitate" (DNR) orders when appropriate. This analysis of data from a previous randomized trial of RRS found that such teams did in fact result in a significant increase in DNR orders compared to hospitals without RRS, although the magnitude of this effect was small (approximately 4 additional DNR orders per 10,000 admissions). Though widely implemented, RSS remain controversial due to conflicting evidence regarding their effectiveness on clinical outcomes. 
Hillman K, Chen J, Cretikos M, et al. Lancet. 2005;365:2091-7.
This study examined the impact of medical emergency teams (METs), also known as rapid response teams (RRTs), on cardiac arrests, transfers to an intensive care unit (ICU), and deaths. The 23-hospital Australian study evaluated the availability of METs at designated hospitals and collected data prior to and during the six months following implementation. Findings suggested more calls for the emergency team but no difference in primary or secondary outcomes. However, the authors point out that even at hospitals with METs in place, inadequate utilization occurred for patients who met clinical criteria. They conclude that despite similar outcomes in both hospital groups, system-based interventions can support a focus on improved monitoring of patients and appropriate response by clinicians.