The medical emergency team system and not-for-resuscitation orders: results from the MERIT Study.
Rapid response systems (RRS, sometimes also termed medical emergency teams) are designed to intervene promptly on inpatients whose clinical condition is acutely deteriorating. Early RRS studies also demonstrated an additional role: evaluating the goals of care and potentially instituting "do-not resuscitate" (DNR) orders when appropriate. This analysis of data from a previous randomized trial of RRS found that such teams did in fact result in a significant increase in DNR orders compared to hospitals without RRS, although the magnitude of this effect was small (approximately 4 additional DNR orders per 10,000 admissions). Though widely implemented, RSS remain controversial due to conflicting evidence regarding their effectiveness on clinical outcomes.