The evolving story of medical emergency teams in quality improvement

André Amaral,Kaveh G Shojania

doi:10.1186/cc8033

Abstract

Adverse events affect approximately 3% to 12% of hospitalized patients. At least a third, but as many as half, of such events are considered preventable. Detection of these events requires investments of time and money. A report in a recent issue of Critical Care used the medical emergency team activation as a trigger to perform a prospective standardized evaluation of charts. The authors observed that roughly one fourth of calls were related to a preventable adverse event, which is comparable to the previous literature. However, while previous studies relied on retrospective chart reviews, this study introduced the novel element of real-time characterization of events by the team at the moment of consultation. This methodology captures important opportunities for improvements in local care at a rate far higher than routine incident-reporting systems, but without requiring substantial investments of additional resources. Academic centers are increasingly recognizing engagement in quality improvement as a distinct career pathway. Involving such physicians in medical emergency teams will likely facilitate the dual roles of these as a clinical outreach arm of the intensive care unit and in identifying problems in care and leading to strategies to reduce them.

Highlights

As Iyengar and colleagues [1] report in a recent issue of Critical Care, medical emergency teams (METs), known widely in North America as rapid response teams, may provide just such a method
Adverse events, defined as undesirable outcomes caused by medical care rather than underlying disease processes, affect approximately 3% to 12% of hospitalized patients
While the evidence regarding their success in improving patient outcomes remains conflicting [7,8], METs likely achieve other benefits, such as increasing nurse satisfaction and retention, and may identify specific quality improvement targets related to recurring problems encountered [9]

Summary

Introduction

As Iyengar and colleagues [1] report in a recent issue of Critical Care, medical emergency teams (METs), known widely in North America as rapid response teams, may provide just such a method. Adverse events, defined as undesirable outcomes caused by medical care rather than underlying disease processes, affect approximately 3% to 12% of hospitalized patients. Especially in the case of chart review, missing information often limits the ability of reviewers to identify adverse events or judge their preventability.

Results

Conclusion