Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital
Background: Rapid Response Systems are hospital-wide patient-focused systems aiming to improve recognition of acute deterioration in patients and trigger a rapid response aimed at preventing potentially avoidable adverse events such as cardiac arrest and death. In 1994, the Royal Children’s Hospital...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424002741 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846113679457648640 |
|---|---|
| author | Jason Acworth Connor Ryan Elliott Acworth Syeda Farah Zahir |
| author_facet | Jason Acworth Connor Ryan Elliott Acworth Syeda Farah Zahir |
| author_sort | Jason Acworth |
| collection | DOAJ |
| description | Background: Rapid Response Systems are hospital-wide patient-focused systems aiming to improve recognition of acute deterioration in patients and trigger a rapid response aimed at preventing potentially avoidable adverse events such as cardiac arrest and death. In 1994, the Royal Children’s Hospital in Brisbane, Australia, was one of the first institutions to adopt a paediatric rapid response system (RRS). The purpose of this study was to investigate the impacts of both introduction of a paediatric RRS and increasing RRS activations (MET dose) on hospital mortality. Methods: Prospectively collected data from institutional databases at a specialist paediatric hospital was used to determine hospital mortality rate pre- and post- implementation of the RRS. An interrupted time series model using segmented regression was utilised to assess the pre-intervention trend, as well as immediate and sustained effects of RRS implementation on hospital mortality. Univariate linear regression examined potential effects of MET dose on mortality. Results: Hospital mortality rate did not change significantly over 15 years before RRS implementation. In the first year after implementation, mortality rate fell significantly (−1.4; 95 %CI −2.27 to −0.52; p = 0.0027). For each year that passed after the intervention, there was no significant change in hospital mortality rate (Estimate: −0.08; 95 %CI −0.17 to 0.02; p = 0.11). Univariate linear regression modelling showed that with every unit increase in MET Dose, hospital mortality rate decreased by −0.13 (95 % CI: −0.27 to 0; p = 0.05). Conclusions: Utilising data from one of the earliest and longest duration single-centre cohort of paediatric MET events, this study reaffirms the association between implementation of a paediatric RRS and decreased hospital mortality. The study also provides novel evidence of the impact of MET dose on patient outcome in the paediatric population. It is recommended that factors influencing the benefit of rapid response systems in paediatric populations are further identified so that this life saving initiative can be optimised. |
| format | Article |
| id | doaj-art-dbee9f644b8447c1a70a07fc6d2d2bc9 |
| institution | Kabale University |
| issn | 2666-5204 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-dbee9f644b8447c1a70a07fc6d2d2bc92024-12-21T04:29:58ZengElsevierResuscitation Plus2666-52042024-12-0120100823Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospitalJason Acworth0Connor Ryan1Elliott Acworth2Syeda Farah Zahir3Queensland Children’s Hospital, 501 Stanley St, South Brisbane, QLD 4101, Australia; Faculty of Medicine, University of Queensland, Herston Rd, Herston, QLD 4006, Australia; Corresponding author at: Medical Lead, Rapid Response System, Queensland Children's Hospital, Australia.Faculty of Medicine, University of Queensland, Herston Rd, Herston, QLD 4006, AustraliaGold Coast University Hospital, 1 Hospital Blvd, Southport, QLD 4215, AustraliaCentre for Health Services Research, Faculty of Medicine, University of Queensland, QLD, AustraliaBackground: Rapid Response Systems are hospital-wide patient-focused systems aiming to improve recognition of acute deterioration in patients and trigger a rapid response aimed at preventing potentially avoidable adverse events such as cardiac arrest and death. In 1994, the Royal Children’s Hospital in Brisbane, Australia, was one of the first institutions to adopt a paediatric rapid response system (RRS). The purpose of this study was to investigate the impacts of both introduction of a paediatric RRS and increasing RRS activations (MET dose) on hospital mortality. Methods: Prospectively collected data from institutional databases at a specialist paediatric hospital was used to determine hospital mortality rate pre- and post- implementation of the RRS. An interrupted time series model using segmented regression was utilised to assess the pre-intervention trend, as well as immediate and sustained effects of RRS implementation on hospital mortality. Univariate linear regression examined potential effects of MET dose on mortality. Results: Hospital mortality rate did not change significantly over 15 years before RRS implementation. In the first year after implementation, mortality rate fell significantly (−1.4; 95 %CI −2.27 to −0.52; p = 0.0027). For each year that passed after the intervention, there was no significant change in hospital mortality rate (Estimate: −0.08; 95 %CI −0.17 to 0.02; p = 0.11). Univariate linear regression modelling showed that with every unit increase in MET Dose, hospital mortality rate decreased by −0.13 (95 % CI: −0.27 to 0; p = 0.05). Conclusions: Utilising data from one of the earliest and longest duration single-centre cohort of paediatric MET events, this study reaffirms the association between implementation of a paediatric RRS and decreased hospital mortality. The study also provides novel evidence of the impact of MET dose on patient outcome in the paediatric population. It is recommended that factors influencing the benefit of rapid response systems in paediatric populations are further identified so that this life saving initiative can be optimised.http://www.sciencedirect.com/science/article/pii/S2666520424002741Rapid response systemMedical Emergency TeamPaediatricClinical deterioration |
| spellingShingle | Jason Acworth Connor Ryan Elliott Acworth Syeda Farah Zahir Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital Resuscitation Plus Rapid response system Medical Emergency Team Paediatric Clinical deterioration |
| title | Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital |
| title_full | Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital |
| title_fullStr | Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital |
| title_full_unstemmed | Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital |
| title_short | Effect of introduction of a rapid response system and increasing Medical Emergency Team (MET) activity on mortality over a 20-year period in a paediatric specialist hospital |
| title_sort | effect of introduction of a rapid response system and increasing medical emergency team met activity on mortality over a 20 year period in a paediatric specialist hospital |
| topic | Rapid response system Medical Emergency Team Paediatric Clinical deterioration |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424002741 |
| work_keys_str_mv | AT jasonacworth effectofintroductionofarapidresponsesystemandincreasingmedicalemergencyteammetactivityonmortalityovera20yearperiodinapaediatricspecialisthospital AT connorryan effectofintroductionofarapidresponsesystemandincreasingmedicalemergencyteammetactivityonmortalityovera20yearperiodinapaediatricspecialisthospital AT elliottacworth effectofintroductionofarapidresponsesystemandincreasingmedicalemergencyteammetactivityonmortalityovera20yearperiodinapaediatricspecialisthospital AT syedafarahzahir effectofintroductionofarapidresponsesystemandincreasingmedicalemergencyteammetactivityonmortalityovera20yearperiodinapaediatricspecialisthospital |