Use of medical emergency team responses to reduce hospital cardiopulmonary arrests
- M A DeVita1,
- R S Braithwaite2,
- R Mahidhara3,
- S Stuart4,
- M Foraida4,
- R L Simmons3,
- and members of the Medical Emergency Response Improvement Team (MERIT)*
- 1Patient Safety Program, Department of Critical Care Medicine, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA, USA
- 2Patient Safety Program, Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- 3Patient Safety Program, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- 4University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA, USA
- Correspondence to: Dr M A DeVita University of Pittsburgh Medical Center Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA 15213;
- Accepted 3 January 2004
Background: Medical emergency team (MET) responses have been implemented to reduce inpatient mortality, but data on their efficacy are sparse and there have been no reports to date from US hospitals.
Objectives: To determine how the incidence and outcomes of cardiac arrests have changed following increased use of MET.
Methods: Objective criteria for MET activation were created and disseminated as part of a crisis management program, after which there was a rapid and sustained increase in the use of MET. A retrospective analysis of clinical outcomes was performed to compare the incidence and mortality of cardiopulmonary arrest before and after the increased use of MET.
Results: A retrospective analysis of 3269 MET responses and 1220 cardiopulmonary arrests over 6.8 years showed an increase in MET responses from 13.7 to 25.8 per 1000 admissions (p<0.0001) after instituting objective activation criteria. There was a coincident 17% decrease in the incidence of cardiopulmonary arrests from 6.5 to 5.4 per 1000 admissions (p = 0.016). The proportion of fatal arrests was similar before and after the increase in use of MET.
Conclusions: Increased use of MET may be associated with fewer cardiopulmonary arrests.
↵* See end of article for list of members of Medical Emergency Response Improvement Team.
MERIT Committee: D Annonio RN, N Bircher MD, K Castelnuovo, C Colleen, K Drain, G Gotaskie RN, W Grbach RN, C Griffin RN, L Haas RN, J Hanna RN, C Herisko MSN, RN, M Hudak RN, D Konop RN, J Kowiatek PharmD, P Matthews RN, J McWilliams RN, N Mininni MSN, RN, V Mossesso MD, P Natale RN, P O’Driscoll, J Phillips, C Schollee RN, D Shearn RN, T Smitherman MD, S Svec RN, V Tappe RN, A Towers MD, J Turka RN, D Zimmer RN.
See editorial commentary, p 247