The relationship between early emergency team calls and serious adverse events*
- 1 January 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 37 (1), 148-153
- https://doi.org/10.1097/ccm.0b013e3181928ce3
Abstract
To examine the relationship between early emergency team calls and the incidence of serious adverse events--cardiac arrests, deaths, and unplanned admissions to an intensive care unit--in a cluster randomized controlled trial of medical emergency team implementation (the MERIT study). Post hoc analysis of data from cluster randomized controlled trial. Twenty-three public hospitals in Australia and 741,744 patients admitted during the conduct of the study. Attendance by a rapid response system team or cardiac arrest team. The relationship between the proportion of rapid response system team calls that were early emergency team calls (defined as calls not associated with cardiac arrest or death) and the rate (events/1000 admissions) of the adverse events. We analyzed 11,242 serious adverse events and 3700 emergency team calls. For every 10% of increase in the proportion of early emergency team calls there was a 2.0 reduction per 10,000 admissions in unexpected cardiac arrests (95% confidence interval [CI] -2.6 to -1.4), a 2.2 reduction in overall cardiac arrests (95% CI -2.9 to -1.6), and a 0.94 reduction in unexpected deaths (95% CI -1.4 to -0.5). We found no such relationship for unplanned intensive care unit admissions or for the aggregate of unexpected cardiac arrests, unplanned intensive care unit admissions, and unexpected deaths. As the proportion of early emergency team calls increases, the rate of cardiac arrests and unexpected deaths decreases. This inverse relationship provides support for the notion that early review of acutely ill ward patients by an emergency team is desirable.This publication has 13 references indexed in Scilit:
- Rapid response systems: A systematic review*Critical Care Medicine, 2007
- Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trialThe Lancet, 2005
- Prioritizing interventions to improve rates of thrombolysis for ischemic strokeNeurology, 2005
- Therapeutic delay and reduced functional status six months after thrombolysis for acute myocardial infarctionThe American Journal of Cardiology, 2004
- Use of medical emergency team (MET) responses to detect medical errorsQuality and Safety in Health Care, 2004
- A clinical model for health services research—the medical emergency teamJournal of Critical Care, 2003
- Redefining in-hospital resuscitation: the concept of the medical emergency teamResuscitation, 2001
- UNEQUALLY SPACED PANEL DATA REGRESSIONS WITH AR(1) DISTURBANCESEconometric Theory, 1999
- The Golden Hour and the Silver Day: Detection and Correction of Occult Hypoperfusion within 24 Hours Improves Outcome from Major TraumaJournal Of Trauma-Injury Infection and Critical Care, 1999
- The Medical Emergency TeamAnaesthesia and Intensive Care, 1995