Patient safety on the otolaryngology service: the role of an established rapid response system.
OBJECTIVE
To study the medical emergencies occurring on a tertiary otolaryngology service identified using a rapid response system (RRS).


METHODS
Retrospective chart review of RRS activations during 21 months.


METHODS
Specialised otolaryngology care unit within the University of Pittsburgh Medical Center Presbyterian/Montefiore Hospital, a tertiary, academic, teaching hospital in the USA.


METHODS
None.


RESULTS
1171 unit admissions. Unit mortality was 5.1/1000 admissions. 53 patients were involved in 67 RRS activations (4/53 deaths). 32 of 67 events were due to respiratory derangements, most commonly pneumonia. 18 of 67 events were due to cardiovascular abnormalities, most commonly hypertension and myocardial infarction. 11 of 67 events were secondary to mental status changes, several of which were related to adverse drug events. 6 of 67 events were secondary to acute bleeding. 23 of 67 events occurred within 24 h of patient transfer/admission, 14 of those after operations. RRS activation was a marker for in-hospital death (RR 42.2, 95% CI 7.9 to 225.2) compared with that in patients not activating the RRS.


CONCLUSIONS
Although otolaryngology care units attempt to prevent adverse events, emergencies still occur. RRSs identify deteriorating otolaryngology patients who are at increased risk for mortality. RRSs are an efficient mechanism of intervention during a medical emergency. RRSs provide a convenient method of identifying medical/system errors and educational opportunities.
Oliver
C L
CL
Head and Neck Surgical Specialists, 799 E. Hampden Ave. Suite 530, Englewood, CO 80113, USA. christopher.oliver@healthonecares.com
Devita
M A
MA
Dunwoody
C J
CJ
Johnson
J T
JT
Sok
J C
JC
Simmons
R L
RL
D003422:Critical Care / Q000379:methods*; D006801:Humans; D010036:Otolaryngology / Q000592:standards*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D017751:Safety Management