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Published in: Critical Care 1/2006

01-02-2006 | Commentary

Introduction of a rapid response system: why we are glad we MET

Authors: Daryl Jones, Rinaldo Bellomo

Published in: Critical Care | Issue 1/2006

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Abstract

Hospital patients can experience serious adverse events during their stay. To identify, review and treat these patients and to prevent serious adverse events, we introduced a medical emergency team (MET) service into our hospital in September 2000 following a 1-year period of preparation and education. The introduction of the MET into our institution has been associated with profound changes to cultural and medical practice that have affected the way in which the intensive care unit and the hospital view the roles of junior doctors, nurses, intensive care physicians, and senior doctors. These changes have also been associated with a progressive reduction in the incidence of cardiac arrests of close to 70%. Furthermore, they have allowed improved analysis and characterization of 'at-risk' patients and their needs. Four years later, we remain glad we MET.
Literature
1.
go back to reference McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA: The quality of health care delivery to adults in the United States. N Engl J Med 2003, 348: 2635-2645. 10.1056/NEJMsa022615CrossRefPubMed McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA: The quality of health care delivery to adults in the United States. N Engl J Med 2003, 348: 2635-2645. 10.1056/NEJMsa022615CrossRefPubMed
2.
go back to reference Brennan TA, Leape LL, Laird N, Hebert L, Localio AR, Lawthers AG, Newhouse JP, Weiler PC, Hiatt HH: Incidence of adverse events and negligence in hospitalised patients: results of the Harvard Medical Practice Study I. N Engl J Med 1991, 324: 370-376.CrossRefPubMed Brennan TA, Leape LL, Laird N, Hebert L, Localio AR, Lawthers AG, Newhouse JP, Weiler PC, Hiatt HH: Incidence of adverse events and negligence in hospitalised patients: results of the Harvard Medical Practice Study I. N Engl J Med 1991, 324: 370-376.CrossRefPubMed
3.
go back to reference Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD: The quality in Australian health care study. Med J Aust 1995, 163: 458-471.PubMed Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD: The quality in Australian health care study. Med J Aust 1995, 163: 458-471.PubMed
4.
go back to reference Franklin C, Mathew J: Developing strategies to prevent in-hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 1994, 22: 244-247.CrossRefPubMed Franklin C, Mathew J: Developing strategies to prevent in-hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 1994, 22: 244-247.CrossRefPubMed
5.
go back to reference Shein RMH, Hazday N, Pena M, Ruben BH, Sprung CL: Clinical antecedents to in-hospital cardiopulmonary arrests. Chest 1990, 98: 1388-1392.CrossRef Shein RMH, Hazday N, Pena M, Ruben BH, Sprung CL: Clinical antecedents to in-hospital cardiopulmonary arrests. Chest 1990, 98: 1388-1392.CrossRef
6.
go back to reference Kause J, Smith G, Prytherch D, Parr M, Flabouris A, Hillman KM: A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom: The ACADEMIA study. Resuscitation 2004, 62: 275-282. 10.1016/j.resuscitation.2004.05.016CrossRefPubMed Kause J, Smith G, Prytherch D, Parr M, Flabouris A, Hillman KM: A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom: The ACADEMIA study. Resuscitation 2004, 62: 275-282. 10.1016/j.resuscitation.2004.05.016CrossRefPubMed
7.
go back to reference Lee A, Bishop G, Hillman KM, Daffurn K: The medical emergency team. Anaesth Intens Care 1995, 23: 183-186. Lee A, Bishop G, Hillman KM, Daffurn K: The medical emergency team. Anaesth Intens Care 1995, 23: 183-186.
8.
go back to reference Nardi G, Riccioni L, Cerchiari E, De Blasio E, Gristina G, Oransky M, Pallotta F, Ajmone-Cat C, Freni C, Trombetta S, et al.: Impact of an integrated treatment approach to the severley injured patients (ISS > 16) on hospital mortality and quality of care. Minerva Anesthesiol 2002, 68: 25-35. Nardi G, Riccioni L, Cerchiari E, De Blasio E, Gristina G, Oransky M, Pallotta F, Ajmone-Cat C, Freni C, Trombetta S, et al.: Impact of an integrated treatment approach to the severley injured patients (ISS > 16) on hospital mortality and quality of care. Minerva Anesthesiol 2002, 68: 25-35.
9.
go back to reference Fresco C, Carinci F, Maggioni AP, Ciampi A, Nicolucci A, Santoro E, Tavazzi L, Tognonia G: Very early assessment of risk for in-hospital death among 11,483 patients with acute myocardial infarction. GISSI investigators. Am Heart J 1999, 138: 1058-1064. 10.1016/S0002-8703(99)70070-0CrossRefPubMed Fresco C, Carinci F, Maggioni AP, Ciampi A, Nicolucci A, Santoro E, Tavazzi L, Tognonia G: Very early assessment of risk for in-hospital death among 11,483 patients with acute myocardial infarction. GISSI investigators. Am Heart J 1999, 138: 1058-1064. 10.1016/S0002-8703(99)70070-0CrossRefPubMed
10.
go back to reference Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M, Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001, 345: 1368-1377. 10.1056/NEJMoa010307CrossRefPubMed Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M, Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001, 345: 1368-1377. 10.1056/NEJMoa010307CrossRefPubMed
11.
go back to reference Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, Silvester W, Doolan L, Gutteridge G: A prospective before-and-after trial of a medical emergency team. Med J Aust 2003, 179: 283-287.PubMed Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, Silvester W, Doolan L, Gutteridge G: A prospective before-and-after trial of a medical emergency team. Med J Aust 2003, 179: 283-287.PubMed
12.
go back to reference Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart G, Opdam H, Silvester W, Doolan L, Gutteridge G: Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med 2004, 32: 916-921. 10.1097/01.CCM.0000119428.02968.9ECrossRefPubMed Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart G, Opdam H, Silvester W, Doolan L, Gutteridge G: Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med 2004, 32: 916-921. 10.1097/01.CCM.0000119428.02968.9ECrossRefPubMed
13.
go back to reference Jones D, Bellomo R, Bates S, Warrillow S, Goldsmith D, Hart G, Opdam H, Gutteridge G: Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Crit Care 2005, 9: R808-R815. 10.1186/cc3906PubMedCentralCrossRefPubMed Jones D, Bellomo R, Bates S, Warrillow S, Goldsmith D, Hart G, Opdam H, Gutteridge G: Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Crit Care 2005, 9: R808-R815. 10.1186/cc3906PubMedCentralCrossRefPubMed
14.
go back to reference Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, Finfer S, Flabouris A, MERIT study investigators: MERIT study investigators. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet 2005, 365: 2091-2097. 10.1016/S0140-6736(05)66733-5CrossRefPubMed Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, Finfer S, Flabouris A, MERIT study investigators: MERIT study investigators. Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet 2005, 365: 2091-2097. 10.1016/S0140-6736(05)66733-5CrossRefPubMed
15.
go back to reference Jones D, Bates S, Warrillow S, Opdam H, Goldsmith D, Gutteridge G, Bellomo R: Circadian pattern of activation of the medical emergency team in a teaching hospital. Crit Care 2005, 9: R303-R306. 10.1186/cc3537PubMedCentralCrossRefPubMed Jones D, Bates S, Warrillow S, Opdam H, Goldsmith D, Gutteridge G, Bellomo R: Circadian pattern of activation of the medical emergency team in a teaching hospital. Crit Care 2005, 9: R303-R306. 10.1186/cc3537PubMedCentralCrossRefPubMed
16.
go back to reference Jones D, Duke G, Green J, Briedis J, Bellomo R, Casamento A, Kattula A, Way M: MET syndromes and an approach to their management. Crit Care 2006, in press. Jones D, Duke G, Green J, Briedis J, Bellomo R, Casamento A, Kattula A, Way M: MET syndromes and an approach to their management. Crit Care 2006, in press.
Metadata
Title
Introduction of a rapid response system: why we are glad we MET
Authors
Daryl Jones
Rinaldo Bellomo
Publication date
01-02-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc4841

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