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ObjectiveTo 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.DesignA 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.SettingMonash Health is a comprehensive healthcare network with 570 adult in-patient beds across four metropolitan teaching hospitals in the south-eastern sector of Melbourne.ResultsThe 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.ConclusionsEngagement 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.

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