Deterioration to decision: a comprehensive literature review of rapid response applications for deteriorating patients in acute care settings

Early detection of clinical deterioration and timely escalation are critical for improving patient safety and preventing subsequent events in hospitals/acute care settings. This paper reviewed existing Rapid Response Systems (RRS) and their applications that incorporate Early Warning Score (EWS) for escalating patient deterioration and rapid response. We identified and analysed response applications and key factors impacting on ward nurses’ ability to recognise and respond to patients deterioration. The literature reports comprise of adoption of various EWS protocols, communication policies, and educational strategies to the specialised healthcare team that have been introduced in the acute care settings to improve patient deterioration workflow. It was found that there are gaps and limitations at different stages of RRS from vital signs collection to escalation and response. Currently, there is no single solution available for clinicians to adopt an efficient escalation workflow. Therefore, there is a clear need for a connected, integrated, user-friendly and effective solution for collection of vital signs to timely escalation and response. Finally, we discussed key gaps and limitations of RRS with future direction and recommendations.