Failure to Rescue

Failure to rescue is shorthand for failure to rescue (i.e., prevent a clinically important deterioration, such as death or permanent disability) from a complication of an underlying illness (e.g., cardiac arrest in a patient with acute myocardial infarction) or a complication of medical care (e.g., major hemorrhage after thrombolysis for acute myocardial infarction). Failure to rescue thus provides a measure of the degree to which providers responded to adverse occurrences (e.g., hospital-acquired infections, cardiac arrest or shock) that developed on their watch. It may reflect the quality of monitoring, the effectiveness of actions taken once early complications are recognized, or both.

The technical motivation for using failure to rescue to evaluate the quality of care stems from the concern that some institutions might document adverse occurrences more assiduously than other institutions. Therefore, using lower rates of in-hospital complications by themselves may simply reward hospitals with poor documentation. However, if the medical record indicates that a complication has occurred, the response to that complication should provide an indicator of the quality of care that is less susceptible to charting bias.