Narrow Results Clear All
Search results for ""
Journal Article > Study
MERIT study investigators. Lancet. 2005;365:2091-2097.
This study examined the impact of medical emergency teams (METs), also known as rapid response teams (RRTs), on cardiac arrests, transfers to an intensive care unit (ICU), and deaths. The 23-hospital Australian study evaluated the availability of METs at designated hospitals and collected data prior to and during the six months following implementation. Findings suggested more calls for the emergency team but no difference in primary or secondary outcomes. However, the authors point out that even at hospitals with METs in place, inadequate utilization occurred for patients who met clinical criteria. They conclude that despite similar outcomes in both hospital groups, system-based interventions can support a focus on improved monitoring of patients and appropriate response by clinicians.
Journal Article > Review
Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward.
Gao H, McDonnell A, Harrison DA, et al. Intensive Care Med. 2007;33:667-79.
Rapid response teams are being widely implemented in hospitals worldwide. These teams are summoned to evaluate patients who meet specific clinical "triggers" (e.g., abnormal vital signs). This systematic review evaluated the ability of such triggers to accurately identify inpatients whose clinical condition is deteriorating. The false-negative rate of commonly used triggers was relatively high, meaning that a significant proportion of acutely unstable patients would not be identified by such criteria. This problem was noted in a prior negative study of rapid response teams. The authors recommend further research to determine the combination of triggers that most accurately identifies clinical instability.
Journal Article > Study
Johnston M, Arora S, King D, Stroman L, Darzi A. Surgery. 2014;155:989-994.
This interview study examined escalation of care, the process by which a patient's deteriorating clinical status is recognized and acted upon, among surgical patients. Attending surgeons, trainees, intensivists, and rapid response team members believe that protocols for escalation of care lack clarity and that there is a dearth of supervision from senior clinicians. Similar to studies of handoffs, direct conversation—either in person or via mobile phone—was deemed preferable to hospital paging systems. Participants identified communication training, explicit and clear protocols, and increased supervision as key to improving the care of deteriorating surgical patients. Accompanying editorials highlight the importance of communication and the need for a safety culture that supports multidisciplinary teams.