A systematic review of rapid response applications based on early warning score for early detection of inpatient deterioration

ABSTRACT

Aim: The aim of this study was to investigate the effectiveness of current rapid response applications available in acute care settings for escalation of patient deterioration. Current challenges and barriers, as well as key recommendations, were also discussed. Methods: We adopted PRISMA review methodology and screened a total of 559 articles. After considering the eligibility and selection criteria, we selected 13 articles published between 2015 and 2019. The selection criteria were based on the inclusion of studies that report on the advancement made to the current practice for providing rapid response to the patient deterioration in acute care settings. Results: We found that current rapid response applications are complicated and time-consuming for detecting inpatient deterioration. Existing applications are either siloed or challenging to use, where clinicians are required to move between two or three different applications to complete an end-to-end patient escalation workflow – from vital signs collection to escalation of deteriorating patients. We found significant differences in escalation and responses when using an electronic tool compared to the manual approach. Moreover, encouraging results were reported in extensive documentation of vital signs and timely alerts for patient deterioration. Conclusion: The electronic vital signs monitoring applications are proved to be efficient and clinically suitable if they are user-friendly and interoperable. As an outcome, several key recommendations and features were identified that would be crucial to the successful implementation of any rapid response system in all clinical settings.

KEYWORDS:

• Rapid response application
• patient deteriorating
• early warning score
• early detection of patient deterioration

Acknowledgments

This research was supported by the Precision Driven Health research partnership.

Author contribution

All authors contributed almost equally and approved the manuscript for review submission.

Compliance with ethical standards

Authors declare no conflict of interest.

Ethical approval: This article does not contain any studies with human participants performed by any of the authors.