Ou L, et al. - Given the implementation of a standardized rapid response system (RRS), called the “Between-the-Flags” (BTF) program, across a large health jurisdiction in Australia in 2010, researchers here examined how RRS influence emergency surgical admissions. The NSW Admitted Patient Data Collection (APDC) was linked with the NSW Registry of Births, Deaths, and Marriages. Using a propensity score-based inverse-probability-weighting adjustment, they measured average treatment effects among treated individuals (prior-RRS hospitals vs prior-non-RRS hospitals) before the BTF implementation (2007–2008) and after (2010–2013). Before BTF, a lower rate of in hospital cardiopulmonary arrests (IHCA) (4.7 vs 7.8 per 1,000 admissions), a lower rate of IHCA related deaths (3.0 vs 4.4 per 1,000 admissions) were reported in patients in prior-RRS hospitals vs those in prior-non-RRS hospitals. The analysis suggests a significant association of BTF program with a significant reduction in IHCA and IHCA deaths for emergency surgical patients in prior-non-RRS hospitals however it was not observed in the prior-RRS hospitals. Both cohorts exhibited improvement in the overall hospital and 30-day mortality after BTF.