The Efficacy of a Two-Tier Rapid Response System

Rapid response systems (RRSs) have been implemented to facilitate the early recognition and treatment of deteriorating ward patients. Evidence of their effectiveness is conflicting, but recent reviews suggest RRS utilization improves patient safety. Aneman et al recently assessed the clinical attributes and outcomes of patients admitted to the ICU of Liverpool Hospital both before and after implementation of a two-tier RRS. In this system, the clinical team responds to less serious first-tier criteria, and the RRS is activated when the patient meets more serious second-tier criteria.

The authors found that ICU mortality rates were significantly lower after two-tier implementation, as compared to mortality rates under the preexisting one-tier RRS. Although this study’s applicability is limited by its retrospective design, implementing a two-tier system seemingly improves patient outcomes.

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