PURPOSE: The purpose of the study was to examine triggers for emergency team activation in hospitals with or without a medical emergency team (MET) system.
MATERIALS AND METHODS: Within a cluster randomized controlled trial examining the effect of introducing a MET system, we recorded the triggers for emergency team activation. We compared the proportion and rate of such triggers in hospitals with or without a MET system and in relation to type of hospital, type of patient ward, and time of day.
RESULTS: In control hospitals, the most common trigger for emergency team activation was a decrease in Glasgow Coma Score by 2 or more points (45.6%), whereas in MET hospitals, it was the fact that staff members were "worried" or the call occurred despite the lack of a "specified reason" (39.3%). In particular, MET hospitals were 35 times more likely to make a call because of staff being "worried" about the patient (14.1% vs 0.4%, P < .001). Control hospitals were also significantly more likely to call an emergency team because of a deteriorating respiratory (P = .003) or pulse (P < .001) rate, more calls had at least 3 triggers for activation (20.8% vs 10.2%, P = .036), and the average number of triggers per call was significantly higher (P = .013). Nonmetropolitan hospitals were more likely to call an emergency team because of respiratory rate abnormalities (33.6% vs 23.2%, P = .015). Coronary care unit calls were more likely to be triggered by abnormalities in pulse rate and systolic blood pressure, and more calls occurred during the period from 6:00 am to noon.
CONCLUSIONS: In MET hospitals, more emergency team calls are triggered because staff members are worried about the patient; and fewer calls have multiple triggers. Type of hospital, type of ward, and time of day also affect the nature and frequency of triggers for emergency team activation.
AD - Simpson Centre for Health Services Research, University of New South Wales, Sydney, New South Wales, Australia. jackchen@unsw.edu.au AN - 20189754 BT - Journal of Critical Care ET - 2010/03/02 LA - eng M1 - 2 N1 - Chen, JackBellomo, RinaldoHillman, KenFlabouris, ArthasFinfer, SimonMERIT Study Investigators for the Simpson Centre and the ANZICS Clinical Trials GroupMulticenter StudyRandomized Controlled TrialResearch Support, Non-U.S. Gov'tUnited StatesJournal of critical careJ Crit Care. 2010 Jun;25(2):359.e1-7. Epub 2010 Mar 1. N2 -PURPOSE: The purpose of the study was to examine triggers for emergency team activation in hospitals with or without a medical emergency team (MET) system.
MATERIALS AND METHODS: Within a cluster randomized controlled trial examining the effect of introducing a MET system, we recorded the triggers for emergency team activation. We compared the proportion and rate of such triggers in hospitals with or without a MET system and in relation to type of hospital, type of patient ward, and time of day.
RESULTS: In control hospitals, the most common trigger for emergency team activation was a decrease in Glasgow Coma Score by 2 or more points (45.6%), whereas in MET hospitals, it was the fact that staff members were "worried" or the call occurred despite the lack of a "specified reason" (39.3%). In particular, MET hospitals were 35 times more likely to make a call because of staff being "worried" about the patient (14.1% vs 0.4%, P < .001). Control hospitals were also significantly more likely to call an emergency team because of a deteriorating respiratory (P = .003) or pulse (P < .001) rate, more calls had at least 3 triggers for activation (20.8% vs 10.2%, P = .036), and the average number of triggers per call was significantly higher (P = .013). Nonmetropolitan hospitals were more likely to call an emergency team because of respiratory rate abnormalities (33.6% vs 23.2%, P = .015). Coronary care unit calls were more likely to be triggered by abnormalities in pulse rate and systolic blood pressure, and more calls occurred during the period from 6:00 am to noon.
CONCLUSIONS: In MET hospitals, more emergency team calls are triggered because staff members are worried about the patient; and fewer calls have multiple triggers. Type of hospital, type of ward, and time of day also affect the nature and frequency of triggers for emergency team activation.
PY - 2010 SN - 1557-8615 (Electronic)0883-9441 (Linking) SP - 359 e1 EP - 7 T2 - Journal of Critical Care TI - Triggers for emergency team activation: a multicenter assessment VL - 25 ER -