Operational characteristics of a hospital rapid response team for public-area emergencies: a retrospective study

A rapid response system (RRS) is widely used to identify and manage clinical deterioration in hospitalized patients. However, acute medical emergencies occurring in hospital public areas remain underexplored. This study aimed to describe the incidence pattern, clinical and operational characteristics of the RRS activation process, and factors associated with high-risk events among non-inpatient individuals in hospital public areas.

This retrospective single-center study included all RRS activations involving non-inpatient individuals in hospital public areas at the main campus of the Second Affiliated Hospital, Zhejiang University School of Medicine, between January 2015 and December 2025. "Non-inpatient individuals" were defined as individuals who were not admitted to inpatient beds and were not under continuous bedside monitoring at the event location. Data regarding event location, trigger reason, activator identity, response time, on-site interventions, and patient outcomes were extracted from an intelligent emergency response information platform. Descriptive analyses were performed to evaluate temporal-spatial patterns and operational characteristics. Exploratory univariate analyses were conducted to examine factors associated with event severity.

A total of 217 RRS activations were included. Events occurred mainly in waiting areas (44.24%), outpatient clinical areas (29.49%), and medical examination areas (18.43%), with a clear daytime predominance. Nurses were the most frequent activators (61.75%). The median response time was 3.00 min. Common on-site interventions included oxygen therapy (25.8%), blood glucose monitoring (25.3%), cardiopulmonary resuscitation (11.5%), intravenous medication administration (10.6%), and bag-mask ventilation (9.2%). Most individuals were subsequently transferred to the emergency department (88.94%). Exploratory analyses suggested that older age and trigger reason were associated with a higher likelihood of high-risk events, whereas event location and time period were not significantly associated with severity.

In this retrospective study of 217 public-area RRS activations, emergencies occurred predominantly in waiting areas, outpatient clinical areas, and medical examination areas, and most affected individuals required subsequent emergency department care. These findings suggest that a hospital-wide RRS can provide timely recognition and initial management for public-area emergencies involving non-inpatient individuals. Spatially distributed coverage, standardized response workflows, and digital process monitoring may contribute to improved emergency preparedness for non-inpatient individuals in hospital public areas.