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Diurnal Variation in Medical Emergency Team Calls at a Tertiary Care Children's Hospital

Susan R Conway1,2, Ken Tegtmeyer1,3, Derek S Wheeler4,5

  • 1Division of Critical Care Medicine, Children's National Hospital, Washington, D.C.

Pediatric Quality & Safety
|September 28, 2020
PubMed

Insights

Medical emergency teams (METs) are activated more during the day and on weekdays than at night and on weekends. This variation suggests potential inconsistencies in detecting deteriorating patients. Further study is needed.

Area of Science:

  • Pediatric critical care medicine
  • Hospital patient safety
  • Clinical workflow analysis

Background:

  • Medical emergency teams (METs) provide critical care to deteriorating hospital patients.
  • Understanding MET activation patterns is crucial for identifying potential gaps in patient monitoring.

Purpose of the Study:

  • To investigate diurnal and weekday/weekend variations in MET activation rates at a tertiary children's hospital.
  • To determine if these variations correlate with patient outcomes or nursing shift changes.

Main Methods:

  • Retrospective cohort study of MET calls from January 2008 to May 2014.
  • Analysis of MET activation rates by time of day, day of week, and proximity to nursing shift change.
  • Comparison of patient disposition following MET activation.

Main Results:

  • MET activation rates were higher during the day compared to night (0.7 vs 0.6 calls/shift, P < 0.001).
  • Weekday MET activations exceeded weekend rates (1.4 vs 1.2 calls/day, P < 0.001).
  • Daytime MET activations more frequently resulted in ICU or OR transfer (61.9% vs 52.9%, P < 0.001).

Conclusions:

  • Significant diurnal and weekday/weekend variations exist in MET activation rates at a large children's hospital.
  • These variations may indicate inconsistent detection of deteriorating patients.
  • Further research is warranted to explore the implications of these activation patterns.

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