• Jack Chen, Lixin Ou, Ken Hillman, Arthas Flabouris, Rinaldo Bellomo, Stephanie J Hollis, and Hassan Assareh.
• Simpson Centre for Health Services Research, Australian Institute of Health Innovation & South Western Clinical School, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: jackchen@unsw.edu.au.
• Resuscitation. 2014 Sep 1;85(9):1275-81.

AimsTo compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia.MethodsFor the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010. We compared the rates of in-hospital cardiopulmonary arrest (IHCA), IHCA-related mortality, overall hospital mortality and 1-year post discharge mortality after IHCA between the RRS hospital and the non-RRS hospitals based on three separate analyses: (1) pooled analysis during 2002-2008; (2) before-after difference between 2008 and 2009; (3) after implementation in 2009.ResultsDuring the 2002-2008 period, the mature RRS hospital had a greater than 50% lower IHCA rate, a 40% lower IHCA-related mortality, and 6% lower overall hospital mortality. Compared to 2008, in their first year of RRS (2009) two hospitals achieved a 22% reduction in IHCA rate, a 22% reduction in IHCA-related mortality and an 11% reduction in overall hospital mortality. During the same time, the mature RRS hospital showed no significant change in those outcomes but, in 2009, it still achieved a crude 20% lower IHCA rate, and a 14% lower overall hospital mortality rate. There was no significant difference in 1-year post-discharge mortality for survivors of IHCA over the study period.ConclusionsImplementation of a RRS was associated with a significant reduction in IHCA, IHCA-related mortality and overall hospital mortality.Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

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