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Journal Article > Study
Unplanned transfers to a medical intensive care unit: causes and relationship to preventable errors in care.
Bapoje SR, Gaudiani JL, Narayanan V, Albert RK. J Hosp Med. 2011;6:68-72.
Patients should improve, not worsen, after hospital admission, and therefore safety interventions such as rapid response teams (RRTs) have been developed specifically to detect and manage unexpected clinical deterioration. This retrospective review of 152 unplanned transfers to the intensive care unit (ICU) at a teaching hospital found that only 15% of unplanned transfers could have been prevented by different management after admission. The most common reason for unplanned ICU transfer was incorrect triage (i.e., the patient should have been admitted directly to the ICU from the emergency department). This study challenges the utility of RRTs in preventing adverse clinical outcomes, and instead identifies the emergency department–inpatient handover as a possible area of focus for quality improvement interventions.
Journal Article > Commentary
Bogert S, Ferrell C, Rutledge DN. Medsurg Nurs. 2010;19:215-222.
The central tenet behind rapid response systems (RRS) is that any provider should be able to summon prompt assistance if concerned about a patient. In the spirit of the National Patient Safety Goal that calls for engaging patients in safety efforts, some hospitals are now allowing patients and families to call the rapid response team directly. This report from a community hospital discusses the education and implementation process and describes the first series of RRS calls initiated by family members. Many of the family-initiated calls revealed communication issues between patients and clinicians, which the RRS was able to successfully negotiate.
Special or Theme Issue
Frush KS, Hohenhaus SM, eds. Clin Ped Emerg Med. 2006;7:213-277.
This special issue provides 11 articles on various aspects of ensuring safety in pediatric emergency care, including the use of rapid response teams and family involvement in care.