BACKGROUND: Medical Emergency Teams (MET) have been developed to identify, review and manage acutely unwell ward patients. Previous studies have suggested that there may be obstacles to the utilization and activation of the MET. AIMS: To determine the effect of a detailed education programme on the rate of utilization of the MET system 3.5 years after its introduction in a University teaching hospital. METHODS: Prospective interventional study involving a detailed programme of education, feedback and decision support for nursing and medical staff given before, during and after implementation of a MET system. We measured the number of MET calls per month for both medical and surgical patients for 109 250 consecutive admissions to the acute care campus of Austin Health from August 2000 to June 2004. RESULTS: Overall activation of the MET increased from 25 calls per month to a peak of 79 calls per month over the study period (average increase of one MET call/month). After standardization for monthly admissions, the increase in MET utilization for surgical patients (increase by 1.13 MET/1000 admissions/month) was 4.9-fold greater than for medical patients (increase by 0.23 MET/1000 admissions/month; P < 0.0001). At the peak level of activity (April 2004), the MET was called to review 8.4% of surgical and 2.7% of medical admissions (P < 0.0001). CONCLUSIONS: There was a progressive increase in the utilization of the MET service in the 3.5 years after implementation, with the rate of uptake 4.9 times greater for surgical than for medical patients. Sustained uptake of the MET system is possible, but increased utilization may take several years to develop. Short-term studies testing the efficacy of the MET system are likely to significantly underestimate its effect on reducing adverse events. Intensive care unit resource adjustments will become necessary to meet increased demand.
BACKGROUND: Medical Emergency Teams (MET) have been developed to identify, review and manage acutely unwell ward patients. Previous studies have suggested that there may be obstacles to the utilization and activation of the MET. AIMS: To determine the effect of a detailed education programme on the rate of utilization of the MET system 3.5 years after its introduction in a University teaching hospital. METHODS: Prospective interventional study involving a detailed programme of education, feedback and decision support for nursing and medical staff given before, during and after implementation of a MET system. We measured the number of MET calls per month for both medical and surgical patients for 109 250 consecutive admissions to the acute care campus of Austin Health from August 2000 to June 2004. RESULTS: Overall activation of the MET increased from 25 calls per month to a peak of 79 calls per month over the study period (average increase of one MET call/month). After standardization for monthly admissions, the increase in MET utilization for surgical patients (increase by 1.13 MET/1000 admissions/month) was 4.9-fold greater than for medical patients (increase by 0.23 MET/1000 admissions/month; P < 0.0001). At the peak level of activity (April 2004), the MET was called to review 8.4% of surgical and 2.7% of medical admissions (P < 0.0001). CONCLUSIONS: There was a progressive increase in the utilization of the MET service in the 3.5 years after implementation, with the rate of uptake 4.9 times greater for surgical than for medical patients. Sustained uptake of the MET system is possible, but increased utilization may take several years to develop. Short-term studies testing the efficacy of the MET system are likely to significantly underestimate its effect on reducing adverse events. Intensive care unit resource adjustments will become necessary to meet increased demand.
Authors: Alexandre Tran; Shannon M Fernando; Daniel I McIsaac; Bram Rochwerg; Garrick Mok; Andrew J E Seely; Dalibor Kubelik; Kenji Inaba; Dennis Y Kim; Peter M Reardon; Jennifer Shen; Peter Tanuseputro; Kednapa Thavorn; Kwadwo Kyeremanteng Journal: Can J Surg Date: 2020-12-09 Impact factor: 2.089
Authors: Eliezer L Bose; Gilles Clermont; Lujie Chen; Artur W Dubrawski; Dianxu Ren; Leslie A Hoffman; Michael R Pinsky; Marilyn Hravnak Journal: J Clin Monit Comput Date: 2017-02-22 Impact factor: 2.502
Authors: Bradford D Winters; Sallie J Weaver; Elizabeth R Pfoh; Ting Yang; Julius Cuong Pham; Sydney M Dy Journal: Ann Intern Med Date: 2013-03-05 Impact factor: 25.391
Authors: Christoph Bergmeir; Irma Bilgrami; Christopher Bain; Geoffrey I Webb; Judit Orosz; David Pilcher Journal: PLoS One Date: 2017-12-27 Impact factor: 3.240
Authors: Marcus Robertson; Andy K H Lim; Ashley Bloom; William Chung; Andrew Tsoi; Elise Cannan; Ben Johnstone; Andrew Huynh; Tessa O'Halloran; Paul Gow; Peter Angus; Daryl Jones Journal: J Clin Med Date: 2021-12-01 Impact factor: 4.241