• Resuscitation · Nov 2019

    Review

    Succeeding with rapid response systems- a never-ending process: A systematic review of how health-care professionals perceive facilitators and barriers within the limbs of the RRS.

    • Siri Lerstøl Olsen, Eldar Søreide, Ken Hillman, and Britt Sætre Hansen.
    • 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.
    • Resuscitation. 2019 Nov 1; 144: 75-90.

    BackgroundMeta-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.ObjectiveTo explore the barriers and facilitators within the limbs of a RRS as described by health-care professionals working within the system.MethodsThe 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.ResultsClear 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.ConclusionTo 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.Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.

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