Siri Lerstøl Olsen1, Eldar Søreide2, Ken Hillman3, Britt Sætre Hansen4. 1. Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 43, 4036 Stavanger, Norway; Division of Medicine, Department of Emergency Medicine, Stavanger University Hospital, Gerd Ragna Bloch Thorsens Gate 8, 4011 Stavanger, Norway. Electronic address: siri.l.olsen@uis.no. 2. Critical Care and Anaesthesiology Research Group Stavanger University Hospital, Gerd Ragna Bloch Thorsens Gate 8, 4011 Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway. 3. Liverpool Hospital, University of New South Wales (SWS Clinical School), c/o Intensive Care Unit Liverpool Hospital Liverpool, NSW, 2170 Australia; The Simpson Centre for Health Services Research, University of New South Wales, Ingham Institute for Applied Medical Research, Australia. 4. Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 43, 4036 Stavanger, Norway; Research Department, Stavanger University Hospital, Gerd Ragna Bloch Thorsens Gate 8, 4011 Stavanger, Norway.
Abstract
BACKGROUND: Meta-analyses show that hospital rapid response systems (RRS) are associated with reduced rates of cardiorespiratory arrest and mortality. However, many RRS fail to provide appropriate outcomes. Thus an improved understanding of how to succeed with a RRS is crucial. By understanding the barriers and facilitators within the limbs of a RRS, these can be addressed. OBJECTIVE: To explore the barriers and facilitators within the limbs of a RRS as described by health-care professionals working within the system. METHODS: The electronic databases searched were: EMBASE, MEDLINE, CINAHL, Epistemonikos, Cochrane, PsychInfo and Web of Science. Search terms were related to RRS and their facilitators and barriers. Studies were appraised guided by the CASP tool. Twenty-one qualitative studies were identified and subjected to content analysis. RESULTS: Clear leadership, interprofessional trust and collaboration seems to be crucial for succeeding with a RRS. Clear protocols, feedback, continuous evaluation and interprofessional training were highlighted as facilitators. Reprimanding down the hierarchy, underestimating the importance of call-criteria, alarm fatigue and a lack of integration with other hospital systems were identified as barriers. CONCLUSION: To succeed with a RRS, the keys seem to lie in the administrative and quality improvement limbs. Clear leadership and continuous quality improvement provide the foundation for the continuing collaboration to manage deteriorating patients. Succeeding with a RRS is a never-ending process.
BACKGROUND: Meta-analyses show that hospital rapid response systems (RRS) are associated with reduced rates of cardiorespiratory arrest and mortality. However, many RRS fail to provide appropriate outcomes. Thus an improved understanding of how to succeed with a RRS is crucial. By understanding the barriers and facilitators within the limbs of a RRS, these can be addressed. OBJECTIVE: To explore the barriers and facilitators within the limbs of a RRS as described by health-care professionals working within the system. METHODS: The electronic databases searched were: EMBASE, MEDLINE, CINAHL, Epistemonikos, Cochrane, PsychInfo and Web of Science. Search terms were related to RRS and their facilitators and barriers. Studies were appraised guided by the CASP tool. Twenty-one qualitative studies were identified and subjected to content analysis. RESULTS: Clear leadership, interprofessional trust and collaboration seems to be crucial for succeeding with a RRS. Clear protocols, feedback, continuous evaluation and interprofessional training were highlighted as facilitators. Reprimanding down the hierarchy, underestimating the importance of call-criteria, alarm fatigue and a lack of integration with other hospital systems were identified as barriers. CONCLUSION: To succeed with a RRS, the keys seem to lie in the administrative and quality improvement limbs. Clear leadership and continuous quality improvement provide the foundation for the continuing collaboration to manage deteriorating patients. Succeeding with a RRS is a never-ending process.
Authors: Bernie Carter; Holly Saron; Lucy Blake; Chin-Kien Eyton-Chong; Sarah Dee; Leah Evans; Jane Harris; Hannah Hughes; Dawn Jones; Caroline Lambert; Steven Lane; Fulya Mehta; Matthew Peak; Jennifer Preston; Sarah Siner; Gerri Sefton; Enitan D Carrol Journal: PLoS One Date: 2022-09-15 Impact factor: 3.752