Ralph is trained as an anesthesiologist-intensivist and is working from 2001 as an consultant intensivist at the Albert Schweitzer hospital (ASZ) in Dordrecht, the Netherlands. From 2007 he is the clinical lead at the ASZ of the committee "MET/ Rapid Response System". In 2008 he joined the national VMS workingparty on "Early detection and treatment of the deteriorating patient on the ward", as part of the Dutch National Safety Program. From 2009 he is also appointed as medical manager of the department of Quality, Safety and Innovation. His main research and PhD-topic is on Rapid Response Systems with a specific interest in "The effect of early identification of and response to clinically deteriorating patients on the surgical ward by using automated continuous patientmonitoring on patientrelated outcomes"; other research interests are team resource management (TRM), individual appraisal & assesment (peer-to-peer), (multidisciplinary) chart analysis, HSMR.