Measures to reduce failure to rescue in the postoperative period

The phenomenon “failure to rescue” indicates that there are differences between hospitals in the detection and management of complications in surgical patients. Adequate and timely treatment of postoperative complications can result in a reduction of preventable deaths and morbidity after at times unpreventable complications. Rapid response systems provide a safety net for adequately handling deteriorating patients experiencing postoperative complications. The main question of this thesis is: can separate parts of the afferent and efferent arm of Rapid Response Systems (RRS) be improved for high-risk surgical patients by continuous wireless monitoring and/or a postoperative anaesthesia visit?
This dissertation entitled Measures to Reduce Failure to Rescue in the Postoperative Period covers the current status of rapid response systems. In part one, the contribution of continuous wireless monitoring systems to rapid response systems in postoperative patients was investigated. It was concluded that remote monitoring systems optimise patient monitoring by continuous and adequate vital sign measurement and can contribute to an early recognition of patient deterioration. In the second part of this thesis it was found that thirty-day mortality was not reduced by a postoperative anesthesia visit. It is unknown whether actual follow-up of anaesthesia recommendations in a high-risk surgical patient group does result in improved patient outcome.