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Viewpoint |

Rapid Response Systems 20 Years Later New Approaches, Old Challenges

Christopher P. Bonafide, MD, MSCE1,2; Damian Roland, MBBS, MRCPCH, PhD3,4; Patrick W. Brady, MD, MSc5,6
[+] Author Affiliations
1Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
2Perelman School of Medicine, University of Pennsylvania, Philadelphia
3Pediatric Emergency Medicine Leicester Academic Group, Leicester Royal Infirmary, Leicester, United Kingdom
4Department of Health Sciences, Social Science Applied to Healthcare Improvement Research Group, University of Leicester, Leicester, United Kingdom
5Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
6Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
JAMA Pediatr. 2016;170(8):729-730. doi:10.1001/jamapediatrics.2016.0398.
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This Viewpoint proposes a set of recommendations for a research agenda aimed at optimizing the identification of deteriorating children to prevent in-hospital cardiopulmonary arrest.

In 1990, Schein and colleagues changed the paradigm of in-hospital cardiopulmonary arrest. Their report, “Clinical Antecedents to In-Hospital Cardiopulmonary Arrest,” provided evidence from adults suggesting that many arrests could have been prevented if existing signs of deterioration were identified, interpreted, communicated, and responded to appropriately.1 Five years later, Liverpool Hospital published the first report of a rapid response system.2 This marked the start of a patient safety movement that spread quickly to children’s hospitals.3

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