University of Tasmania
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Getting more efficient Rapid Response System (RRS) utilization by the use of a general ward based deteriorating patient contract

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journal contribution
posted on 2023-05-19, 10:24 authored by Michael Buist, Marshall, S, Shearer, B, Finnigan, M, Hore, T, Sturgess, T, Wilson, S

Objective: To determine if a general ward-based plan to address the deteriorating patient could improve RRS utilization over and above a mandatory organizational policy and procedure.

Design: A two stage methodology: First, engagement with ward providers and users of the RRS to generate ward-based interventions; Second, measurement of the incidence of missed/delayed RRS calls, RRS calls, cardiac arrests and unplanned intensive care unit admission both prior to the intervention and 12 months post implementation.

Setting: Monash Health is a comprehensive healthcare network with 570 adult in-patient beds across four metropolitan teaching hospitals in the south-eastern sector of Melbourne.

Results: The interventions selected for intervention were: (1) a ward based agreement on how to best locally optimize management of the deteriorating patient,(2) an improved communication protocol, and (3) a revision of the education program for staff. Post intervention the aggregate rate of missed/delayed RRS calls reduced across all wards (1.05 to 0.34 per 1000 bed days, p = 0.049). This occurred without a change in the rate of RRS activation (7.98 per 1000 bed days pre-intervention versus 7.85 bed days post-intervention). The incidence of cardiac arrests or unplanned interventions did not change post intervention.

Conclusions: Engagement of the users of a system like the RRS activation protocol can improve compliance rates with protocols when the users have ownership of the process.


Publication title

Safety in Health






Tasmanian School of Medicine


BioMed Central Ltd.

Place of publication

United Kingdom

Rights statement

Copyright 2015 Buist et al.; licensee BioMed Central. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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