{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:49:42Z","timestamp":1791499782833,"version":"4.3.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,5,1]],"date-time":"2017-05-01T00:00:00Z","timestamp":1493596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:p>Hospital systems for the recognition (afferent limb) and management (efferent limb) of deteriorating patients, or Rapid Response Systems (RRSs), are being mandated worldwide, in spite of conflicting evidence regarding their efficacy. We have evaluated the impact of an Adult Deterioration Detection System (Q\u2013ADDS)\u2013based RRS specifically on illness severity at intensive care unit (ICU) admission and ICU length of stay (LOS), as well as previously studied endpoints. We undertook a retrospective, single-centre observational study comparing equivalent 18-month periods before the Q\u2013ADDS\u2013based RRS, and after implementation. The primary endpoints of the study were illness severity of unplanned ICU admissions from the ward, ICU length of stay, and ICU mortality. Secondary endpoints were RRS call numbers, rate of unplanned ICU admissions, and ward-based cardiorespiratory arrests. Following the introduction of the new RRS, Acute Pain and Chronic Health Evaluation (APACHE) II (17 versus 21, P &lt;0.001), APACHE III (64 versus 68, P=0.011) and Simplified Acute Physiology Score (35 versus 38, P=0.044) scores at ICU admission from the ward were reduced. Fewer patients were in the &gt;50% predicted mortality range of APACHE II (16% versus 32%, P &lt;0.001), APACHE III (18% versus 28%, P=0.012) and Simplified Acute Physiology Score (14% versus 24%, P=0.006). ICU mortality was unchanged (13.7% versus 13.8%, P=0.93). ICU LOS was reduced (3 versus 4 days, P=0.02); prolonged stay (&gt;7 days) was not significantly changed (19% versus 27%, P=0.055). Unplanned ICU admissions, cardiorespiratory arrests and hospital mortality were unchanged. The frequency of RRS activation (48 versus 11 per 1,000 admissions, P &lt;0.001) was markedly increased. This Q\u2013ADDS form\u2013based RRS has resulted in lower illness severity at ICU admission from the ward, and fewer patients with scores associated with a &gt;50% predicted mortality. Overall, ICU length of stay was reduced. These specific outcomes may reliably reflect RRS efficacy, even in smaller centres.<\/jats:p>","DOI":"10.1177\/0310057x1704500313","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T17:47:14Z","timestamp":1547488034000},"page":"369-374","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["The Effect of Rapid Response System Revision on Standard and Specific Intensive Care Unit Outcomes in a Regional Hospital"],"prefix":"10.1177","volume":"45","author":[{"given":"K.","family":"Joshi","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Lyell McEwin Hospital, Elizabeth Vale, South Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Consultant, Intensive Care Unit, Nambour General Hospital, Nambour, Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Landy","sequence":"additional","affiliation":[{"name":"Consultant, Intensive Care Unit, Nambour General Hospital, Nambour, Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. M.","family":"Anstey","sequence":"additional","affiliation":[{"name":"Consultant, Intensive Care Unit, Nambour General Hospital, Nambour, Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Gooch","sequence":"additional","affiliation":[{"name":"Clinical Nurse Coordinator, Nambour General Hospital, Nambour, Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,5,1]]},"reference":[{"key":"bibr1-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1186\/cc11843"},{"key":"bibr2-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7334.387"},{"key":"bibr3-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1634-x"},{"key":"bibr4-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000119428.02968.9E"},{"key":"bibr5-0310057X1704500313","first-page":"77","volume":"17","author":"Frost S.A.","year":"2015","journal-title":"Crit Care Resusc"},{"key":"bibr6-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66733-5"},{"key":"bibr7-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.424"},{"key":"bibr8-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.238"},{"key":"bibr9-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2009532"},{"key":"bibr10-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2005.016956"},{"key":"bibr11-0310057X1704500313","volume-title":"Standard 9. Australian Commission on Safety and Quality in Health Care (ACSQHC)","year":"2011"},{"key":"bibr12-0310057X1704500313","unstructured":"PreeceM.H.W., HorswillM.S., HillA., WatsonM.O. The Development of Adult Deterioration Detection System (ADDS) Chart. Report prepared for the Australian Commission on Safety and Quality in Health Care's program for Recognising and Responding to Clinical Deterioration. May 2010."},{"key":"bibr13-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2006.01045.x"},{"key":"bibr14-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.6.1619"},{"key":"bibr15-0310057X1704500313","first-page":"523","volume":"18","author":"Willmott L.","year":"2011","journal-title":"J Law Med"},{"key":"bibr16-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181d8cc1d"},{"key":"bibr17-0310057X1704500313","doi-asserted-by":"publisher","DOI":"10.1071\/AH13138"}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X1704500313","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X1704500313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:09:49Z","timestamp":1777367389000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X1704500313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1177\/0310057X1704500313"],"URL":"https:\/\/doi.org\/10.1177\/0310057x1704500313","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}