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https://www.readbyqxmd.com/read/29159719/effect-of-a-real-time-electronic-dashboard-on-a-rapid-response-system
#1
Grant S Fletcher, Barry A Aaronson, Andrew A White, Reena Julka
A rapid response system (RRS) may have limited effectiveness when inpatient providers fail to recognize signs of early patient decompensation. We evaluated the impact of an electronic medical record (EMR)-based alerting dashboard on outcomes associated with RRS activation. We used a repeated treatment study in which the dashboard display was successively turned on and off each week for ten 2-week cycles over a 20-week period on the inpatient acute care wards of an academic medical center. The Rapid Response Team (RRT) dashboard displayed all hospital patients in a single view ranked by severity score, updated in real time...
November 20, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29155672/establishment-of-cdc-global-rapid-response-team-to-ensure-global-health-security
#2
Tasha Stehling-Ariza, Adrienne Lefevre, Dinorah Calles, Kpandja Djawe, Richard Garfield, Michael Gerber, Margherita Ghiselli, Coralie Giese, Ashley L Greiner, Adela Hoffman, Leigh Ann Miller, Lisa Moorhouse, Carlos Navarro-Colorado, James Walsh, Dante Bugli, Cyrus Shahpar
The 2014-2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29155668/responding-to-communicable-diseases-in-internationally-mobile-populations-at-points-of-entry-and-along-porous-borders-nigeria-benin-and-togo
#3
Rebecca D Merrill, Kimberly Rogers, Sarah Ward, Olubumni Ojo, Clement Glele Kakaī, Tamekloe Tsidi Agbeko, Hassan Garba, Amanda MacGurn, Marydale Oppert, Idrissa Kone, Olutola Bamsa, Dana Schneider, Clive Brown
Recent multinational disease outbreaks demonstrate the risk of disease spreading globally before public health systems can respond to an event. To ensure global health security, countries need robust multisectoral systems to rapidly detect and respond to domestic or imported communicable diseases. The US Centers for Disease Control and Prevention International Border Team works with the governments of Nigeria, Togo, and Benin, along with Pro-Health International and the Abidjan-Lagos Corridor Organization, to build sustainable International Health Regulations capacities at points of entry (POEs) and along border regions...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29155667/use-of-a-diagonal-approach-to-health-system-strengthening-and-measles-elimination-after-a-large-nationwide-outbreak-in-mongolia
#4
José E Hagan, Ashley Greiner, Ulzii-Orshikh Luvsansharav, Jason Lake, Christopher Lee, Roberta Pastore, Yoshihiro Takashima, Amarzaya Sarankhuu, Sodbayar Demberelsuren, Rachel Smith, Benjamin Park, James L Goodson
Measles is a highly transmissible infectious disease that causes serious illness and death worldwide. Efforts to eliminate measles through achieving high immunization coverage, well-performing surveillance systems, and rapid and effective outbreak response mechanisms while strategically engaging and strengthening health systems have been termed a diagonal approach. In March 2015, a large nationwide measles epidemic occurred in Mongolia, 1 year after verification of measles elimination in this country. A multidisciplinary team conducted an outbreak investigation that included a broad health system assessment, organized around the Global Health Security Agenda framework of Prevent-Detect-Respond, to provide recommendations for evidence-based interventions to interrupt the epidemic and strengthen the overall health system to prevent future outbreaks of measles and other epidemic-prone infectious threats...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29153825/clinician-and-manager-perceptions-of-factors-leading-to-ward-patient-clinical-deterioration
#5
Joshua Allen, Daryl Jones, Judy Currey
BACKGROUND: Improving the timely recognition and response to clinical deterioration is a critical challenge for clinicians, educators, administrators and researchers. Clinical deterioration leading to Rapid Response Team review is associated with poor patient outcomes. A range of factors associated with clinical deterioration and its outcomes have been identified, and may help with early identification of deteriorating patients. However, the relative importance of each factor on the development of clinical deterioration is unknown...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#6
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29141907/emergency-versus-standard-response-time-efficacy-of-london-s-air-ambulance-rapid-response-vehicle
#7
Marius Rehn, Gareth Davies, Paul Smith, David Lockey
OBJECTIVE: The potential increased risk of an emergency response using a rapid response vehicle (RRV) should only be accepted when it allows a clinically significant time saving for management of patients who are critically injured or sick. Air ambulance services often use an RRV to maintain operational resilience. We compared the RRV response time on emergency versus standard driving to inform emergency services of time efficacy of emergency response in an urban environment. METHODS: Prospective observational controlled study of response data of emergency and standard driving...
November 15, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29141770/outcomes-following-changing-from-a-two-tiered-to-a-three-tiered-hospital-rapid-response-system
#8
Winston Cheung
Objectives The aim of the present study was to determine whether changing a hospital rapid response system (RRS) from a two-tiered to a three-tiered model can reduce disruption to normal hospital routines while maintaining the same overall patient outcomes.Methods Staff at an Australian teaching hospital attending medical emergency team and cardiac arrest (MET/CA) calls were interviewed after the RRS was changed from a two-tiered to three-tiered model, and the results were compared with a study using the same methods conducted before the change...
November 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29140185/thrombolysis-improving-door-to-needle-times-for-ischemic-stroke-treatment-a-narrative-review
#9
Noreen Kamal, Eric E Smith, Thomas Jeerakathil, Michael D Hill
Background The effectiveness of thrombolysis is highly time dependent. For this reason, short target times have been set to reduce time to treatment from hospital arrival, which is called door-to-needle time. Summary of review There has been considerable work done at single centers and across multiple hospitals to improve door-to-needle time. There have been reductions of 8 to 47 min when applying one or more improvement strategies at single centers, and there have been many multi-hospital initiatives. The delays to treatment have been attributed to both patient and hospital factors, and strategies to address these delays have been proven to reduce door-to-needle time...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29138016/the-challenges-of-detecting-and-responding-to-a-lassa-fever-outbreak-in-an-ebola-affected-setting
#10
E L Hamblion, P Raftery, A Wendland, E Dweh, G S Williams, R N C George, L Soro, V Katawera, P Clement, A N Gasasira, E Musa, T K Nagbe
OBJECTIVES: Lassa fever(LF), a priority emerging pathogen likely to cause major epidemics, is endemic in much of West Africa and difficult to distinguish from other viral haemorrhagic fevers including Ebola virus disease(EVD). Definitive diagnosis requires laboratory confirmation not widely available in affected settings. We report the public health action to contain a LF outbreak and challenges encountered in an EVD-affected setting. METHODS: In February 2016 a rapid response team was deployed in Liberia in response to a cluster of LF cases...
November 11, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29133019/frequency-and-significance-of-qsofa-criteria-during-adult-rapid-response-team-reviews-a-prospective-cohort-study
#11
Maurice LeGuen, Yvonne Ballueer, Richard McKay, Glenn Eastwood, Rinaldo Bellomo, Daryl Jones
AIM: A new definition of sepsis released by an international task-force has introduced the concept of quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA). This study aimed to measure the proportion of patients who fulfilled qSOFA criteria during a Rapid Response Team (RRT) review and to assess their associated outcomes. METHODS: We conducted a prospective study of adult RRT reviews over a one month period between 6th June and 10th July 2016 in a large tertiary hospital in Melbourne Australia RESULTS: Over a one-month period, there were 282 RRT reviews, 258 of which were included...
November 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29132595/remote-ecls-implantation-and-transport-for-retrieval-of-cardiogenic-shock-patients
#12
Sabina P W Guenther, Stefan Buchholz, Frank Born, Stefan Brunner, René Schramm, Dominik J Hoechter, Vera von Dossow, Maximilian Pichlmaier, Christian Hagl, Nawid Khaladj
OBJECTIVE: Extracorporeal life support (ECLS) emerges as a salvage option in therapy refractory cardiogenic shock but is limited to highly specialized tertiary care centers. Critically ill patients are often too unstable for conventional transport. Mobile ECLS programs for remote implantation and subsequent air or ground-based transport for patient retrieval could solve this dilemma and make full-spectrum advanced cardiac care available to patients in remote hospitals in whom shock otherwise might be fatal...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29131479/measuring-the-success-of-medical-emergency-teams-potentially-preventable-deaths-versus-total-cardiac-arrest-deaths-a-single-centre-observational-study
#13
Jonathan Barrett, Gabrielle Hawdon, Julie Wade, John Reeves
Measuring the success of Medical Emergency Teams: Potentially preventable deaths versus total cardiac arrest deaths. A single centre observational study. BACKGROUND: Rapid response systems (RRS) have been implemented with the aim of preventing patient deterioration, in-hospital cardiac arrests (IHCA) and related deaths. Not all "unexpected deaths" are preventable, thus compromising the use of unexpected deaths as an outcome measure. AIMS: Our aim was to assess temporal trends in potentially preventable deaths as a subset of total unexpected death rates over a four-year period...
November 13, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29124058/implementation-of-a-regional-training-program-on-african-swine-fever-as-part-of-the-cooperative-biological-engagement-program-across-the-caucasus-region
#14
Marco De Nardi, Anaïs Léger, Tatul Stepanyan, Bagrat Khachatryan, Talgat Karibayev, Igor Sytnik, Samat Tyulegenov, Assel Akhmetova, Serhiy Nychyk, Mykola Sytiuk, Oleg Nevolko, Roman Datsenko, Tengiz Chaligava, Lasha Avaliani, Otar Parkadze, Lena Ninidze, Natia Kartskhia, Tsira Napetvaridze, Zviad Asanishvili, Demna Khelaia, Ioseb Menteshashvili, Meruzhan Zadayan, Lyudmila Niazyan, Nataliya Mykhaylovska, Bradford Raymond Brooks, Gulnara Zhumabayeva, Saltanat Satabayeva, Magda Metreveli, Theresa Gallagher, Richard Obiso
A training and outreach program to increase public awareness of African swine fever (ASF) was implemented by Defense Threat Reduction Agency and the Ministries of Agriculture in Armenia, Georgia, Kazakhstan, and Ukraine. The implementing agency was the company SAFOSO (Switzerland). Integration of this regional effort was administered by subject matter experts for each country. The main teaching effort of this project was to develop a comprehensive regional public outreach campaign through a network of expertise and knowledge for the control and prevention of ASF in four neighboring countries that experience similar issues with this disease...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29112046/rapid-response-teams-what-s-the-latest
#15
Shirley A Jackson
No abstract text is available yet for this article.
November 3, 2017: Nursing
https://www.readbyqxmd.com/read/29106880/utility-of-screening-questionnaire-and-polysomnography-to-predict-postoperative-outcomes-in-children
#16
Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R Jatana, Joseph D Tobias, Vidya T Raman
INTRODUCTION: The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. METHODS: Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29097448/using-simulation-to-develop-care-models-for-rapid-response-and-code-teams-at-a-satellite-facility
#17
Amy R L Rule, Julie Snider, Cheryl Marshall, Kathleen Kramer, Gary L Geis, Ken Tegtmeyer, Craig H Gosdin
BACKGROUND: Our institution recently completed an expansion of an acute care inpatient unit within a satellite hospital that does not include an on-site ICU or PICU. Because of expected increases in volume and acuity, new care models for Rapid Response Teams (RRTs) and Code Blue Teams were necessary. OBJECTIVES: Using simulation-based training, our objectives were to define the optimal roles and responsibilities for team members (including ICU physicians via telemedicine), refine the staffing of RRTs and code Teams, and identify latent safety threats (LSTs) before opening the expanded inpatient unit...
November 2, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29072886/rapid-field-response-to-a-cluster-of-illnesses-and-deaths-sinoe-county-liberia-april-may-2017
#18
John Doedeh, Joseph Asamoah Frimpong, Kwuakuan D M Yealue, Himiede W Wilson, Youhn Konway, Samson Q Wiah, Vivian Doedeh, Umaru Bao, George Seneh, Lawrence Gorwor, Sylvester Toe, Emmanuel Ghartey, Lawrence Larway, Dedesco Gweh, Philemon Gonotee, Thomas Paasewe, George Tamatai, James Yarkeh, Samuel Smith, Annette Brima-Davis, George Dauda, Thomas Monger, Leleh W Gornor-Pewu, Siafa Lombeh, Jeremias Naiene, Nathaniel Dovillie, Mark Korvayan, Geraldine George, Garrison Kerwillain, Ralph Jetoh, Suzanne Friesen, Carl Kinkade, Victoria Katawera, Maame Amo-Addae, Roseline N George, Miatta Z Gbanya, E Kainne Dokubo
On April 25, 2017, the Sinoe County Health Team (CHT) notified the Liberia Ministry of Health (MoH) and the National Public Health Institute of Liberia of an unknown illness among 14 persons that resulted in eight deaths in Sinoe County. On April 26, the National Rapid Response Team and epidemiologists from CDC, the World Health Organization (WHO) and the African Field Epidemiology Network (AFENET) in Liberia were deployed to support the county-led response. Measures were immediately implemented to identify all cases, ascertain the cause of illness, and control the outbreak...
October 27, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29039621/supporting-emergency-medical-care-teams-with-an-integrated-status-display-providing-real-time-access-to-medical-best-practices-workflow-tracking-and-patient-data
#19
PoLiang Wu, Min-Young Nam, Jeonghwan Choi, Alex Kirlik, Lui Sha, Richard B Berlin
The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design...
October 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#20
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
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