Developing a medical emergency team running sheet to improve clinical handoff and documentation

During medical emergency team (MET) and cardiac arrest calls, a scribe usually records events on a running sheet. There is more agreement on what data should be recorded in cardiac arrest calls than for MET calls. In addition, handoff (handover) from ward staff to the arriving MET may be variable.

In a quality improvement project, a novel MET running sheet was developed to document events and therapies administered during MET calls. Key characteristics of the form were improved form layout, increased space for event documentation, and prompts to assist handoff to the arriving MET using the Identity Situation, Background, Assessment, Request (ISBAR) format. Ward nurses commonly involved in MET activation were surveyed to assess their perceptions of the new MET running sheet. Files of 100 consecutive MET calls were reviewed to assess compliance.

Of 109 nurses invited to complete the survey, 103 did so (94.5% response rate). Overall, 87 (84.5%) of the 103 respondents agreed or strongly agreed that the new MET running sheet was better than the previous form for documenting MET management, and 58 (57.4%) of 101 respondents agreed or strongly agreed that it assisted handoff. The form was completed in 91 of a sample of 100 consecutive MET calls. Areas of less complete documentation included aspects of the ISBAR handover to the arriving MET and notification of the next of kin and usual clinicians at the completion of the call.

The MET running sheet, tailored to the clinical events that occur during episodes of MET review, may assist handoff from ward nurses to the arriving MET and event documentation.