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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Triggers for emergency team activation: a multicenter assessment.

Jack Chen1, Rinaldo Bellomo, Ken Hillman

  • 1Simpson Centre for Health Services Research, University of New South Wales, Sydney, New South Wales, Australia. jackchen@unsw.edu.au

Journal of Critical Care
|March 2, 2010
PubMed
Summary

Medical emergency team (MET) systems change why hospitals activate emergency teams. MET hospitals more often activate teams due to staff concerns, while control hospitals rely more on specific vital sign changes.

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Area of Science:

  • Medical research
  • Clinical quality improvement
  • Patient safety

Background:

  • Hospitals utilize emergency team activation to manage deteriorating patients.
  • The impact of medical emergency team (MET) systems on activation triggers requires further investigation.
  • Understanding activation patterns is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To compare the triggers for emergency team activation in hospitals with and without a medical emergency team (MET) system.
  • To analyze how hospital type, patient ward, and time of day influence these triggers.

Main Methods:

  • A cluster randomized controlled trial was used to compare hospitals with and without MET systems.
  • Data on triggers for emergency team activation were collected and analyzed.
  • Statistical comparisons were made based on hospital characteristics and time of day.

Main Results:

  • MET hospitals were significantly more likely to activate emergency teams due to "worried" staff (14.1% vs 0.4%) compared to control hospitals.
  • Control hospitals more frequently cited specific physiological changes like decreased Glasgow Coma Score, respiratory rate, or pulse rate as triggers.
  • Calls in control hospitals were more likely to have multiple triggers and a higher average number of triggers per call.

Conclusions:

  • The implementation of a MET system shifts emergency team activation triggers towards staff concern rather than solely objective physiological decline.
  • Fewer emergency calls in MET hospitals involved multiple triggers.
  • Hospital type, ward, and time of day significantly influence the nature and frequency of emergency team activation triggers.