Effects of a rapid response system on quality of life: a prospective cohort study in surgical patients before and after implementing a rapid response system
Effects of a rapid response system on quality of life: a prospective cohort study in surgical patients before and after implementing a rapid response system
Background: the aim of a rapid response system (RRS) is to improve the timely recognition and treatment of ward patients with deteriorating vital signs The system is based on a set of clinical criteria that are used to assess patient’s vital signs on a general ward. Once a patient is evaluated as critical, a medical emergency team is activated to more thoroughly assess the patient’s physical condition and to initiate treatment. The medical emergency team included a critical care physician and a critical care nurse.
Aim: to assess the effect of an RRS on health-related quality of life (HRQOL).
Methods: prospective cohort study in surgical patients before and after implementing an RRS. HRQOL was measured using the EuroQol-5 dimensions (EQ-5D) and the EQ visual analogue scale (VAS) at pre surgery and at 3 and 6 months following surgery.
Results: no statistical significant effects of RRS implementation on the EQ-5D index and EQ-VAS were found. This was also true for the subpopulation of patients with an unplanned intensive care unit admission. Regarding the EQ-5D dimensions, deterioration in the ‘mobility’ and ‘usual activities’ dimensions in the post-implementation group was significantly less compared to the pre-implementation group with a respective mean difference of 0.08 (p?=?0.03) and 0.09 (p?=?0.04) on a three-point scale at 6 months. Lower pre-surgery EQ-5D index and higher American Society of Anesthesiologists physical status (ASA-PS) scores were significantly associated with lower EQ-5D index scores at 3 and 6 months following surgery.
Conclusions: implementation of an RRS did not convincingly affect HRQOL following major surgery. We question if HRQOL is an adequate measure to assess the influence of an RRS. Pre-surgery HRQOL- and ASA-PS scores were strongly associated with HRQOL outcomes and may have abated the influence of the RRS implementation
hospital rapid response team, medical emergency team, quality of life, EuroQol, eneral surgery
1-7
Simmes, Friede
84b132f3-31f0-4334-a426-5c875d45d652
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Mintjes, Joke
730dd3a8-9b71-455c-a333-fa2a1bc1b24d
Fikkers, Bernard G.
8ab71d51-236f-4368-8178-88449685c105
van der Hoeven, Johannes G.
78ca86cf-76cd-4578-b063-649414423b43
1 May 2013
Simmes, Friede
84b132f3-31f0-4334-a426-5c875d45d652
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Mintjes, Joke
730dd3a8-9b71-455c-a333-fa2a1bc1b24d
Fikkers, Bernard G.
8ab71d51-236f-4368-8178-88449685c105
van der Hoeven, Johannes G.
78ca86cf-76cd-4578-b063-649414423b43
Simmes, Friede, Schoonhoven, Lisette, Mintjes, Joke, Fikkers, Bernard G. and van der Hoeven, Johannes G.
(2013)
Effects of a rapid response system on quality of life: a prospective cohort study in surgical patients before and after implementing a rapid response system.
Health and Quality of Life Outcomes, 11, .
(doi:10.1186/1477-7525-11-74).
(PMID:23635080)
Abstract
Background: the aim of a rapid response system (RRS) is to improve the timely recognition and treatment of ward patients with deteriorating vital signs The system is based on a set of clinical criteria that are used to assess patient’s vital signs on a general ward. Once a patient is evaluated as critical, a medical emergency team is activated to more thoroughly assess the patient’s physical condition and to initiate treatment. The medical emergency team included a critical care physician and a critical care nurse.
Aim: to assess the effect of an RRS on health-related quality of life (HRQOL).
Methods: prospective cohort study in surgical patients before and after implementing an RRS. HRQOL was measured using the EuroQol-5 dimensions (EQ-5D) and the EQ visual analogue scale (VAS) at pre surgery and at 3 and 6 months following surgery.
Results: no statistical significant effects of RRS implementation on the EQ-5D index and EQ-VAS were found. This was also true for the subpopulation of patients with an unplanned intensive care unit admission. Regarding the EQ-5D dimensions, deterioration in the ‘mobility’ and ‘usual activities’ dimensions in the post-implementation group was significantly less compared to the pre-implementation group with a respective mean difference of 0.08 (p?=?0.03) and 0.09 (p?=?0.04) on a three-point scale at 6 months. Lower pre-surgery EQ-5D index and higher American Society of Anesthesiologists physical status (ASA-PS) scores were significantly associated with lower EQ-5D index scores at 3 and 6 months following surgery.
Conclusions: implementation of an RRS did not convincingly affect HRQOL following major surgery. We question if HRQOL is an adequate measure to assess the influence of an RRS. Pre-surgery HRQOL- and ASA-PS scores were strongly associated with HRQOL outcomes and may have abated the influence of the RRS implementation
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Simmes et al effects of a rapid response team2013.pdf
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Simmes et al Effects on QoL Rapid Response 2014.pdf
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More information
Accepted/In Press date: 29 April 2013
Published date: 1 May 2013
Keywords:
hospital rapid response team, medical emergency team, quality of life, EuroQol, eneral surgery
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 354742
URI: http://eprints.soton.ac.uk/id/eprint/354742
ISSN: 1477-7525
PURE UUID: aad69bf8-2e11-49a5-85de-18bfb9d4802b
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Date deposited: 22 Jul 2013 09:18
Last modified: 15 Mar 2024 03:41
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Contributors
Author:
Friede Simmes
Author:
Joke Mintjes
Author:
Bernard G. Fikkers
Author:
Johannes G. van der Hoeven
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