• Youlim Kim, Dong Seon Lee, Hyunju Min, Yun Young Choi, Eun Young Lee, Inae Song, Jong Sun Park, Young-Jae Cho, You Hwan Jo, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Sang Hwan Do, and Yeon Joo Lee.
• 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 4Department of Anesthesiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 5Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
• Crit. Care Med. 2017 Jun 1; 45 (6): e592-e599.

ObjectivesTo evaluate the effect of a part-time rapid response system on the occurrence rate of cardiopulmonary arrest by comparing the times of rapid response system operation versus nonoperation.DesignRetrospective cohort study.SettingA 1,360-bed tertiary care hospital.PatientsAdult patients admitted to the general ward were screened. Data were collected over 36 months from rapid response system implementation (October 2012 to September 2015) and more than 45 months before rapid response system implementation (January 2009 to September 2012).InterventionsNone.Measurements And Main ResultsThe rapid response system operates from 7 AM to 10 PM on weekdays and from 7 AM to 12 PM on Saturdays. Primary outcomes were the difference of cardiopulmonary arrest incidence between pre-rapid response system and post-rapid response system periods and whether the rapid response system operating time affects the cardiopulmonary arrest incidence. The overall cardiopulmonary arrest incidence (per 1,000 admissions) was 1.43. Although the number of admissions per month and case-mix index were increased (3,555.18 vs 4,564.72, p < 0.001; 1.09 vs 1.13, p = 0.001, respectively), the cardiopulmonary arrest incidence was significantly decreased after rapid response system (1.60 vs 1.23; p = 0.021), and mortality (%) was unchanged (1.38 vs 1.33; p = 0.322). After rapid response system implementation, the cardiopulmonary arrest incidence significantly decreased by 40% during rapid response system operating times (0.82 vs 0.49/1,000 admissions; p = 0.001) but remained similar during rapid response system nonoperating times (0.77 vs 0.73/1,000 admissions; p = 0.729).ConclusionsThe implementation of a part-time rapid response system reduced the cardiopulmonary arrest incidence based on the reduction of cardiopulmonary arrest during rapid response system operating times. Further analysis of the cost effectiveness of part-time rapid response system is needed.

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