Medical emergency team calls in the radiology department: patient characteristics and outcomes
- Lora K Ott1,
- Michael R Pinsky2,
- Leslie A Hoffman1,
- Sean P Clarke3,
- Sunday Clark2,
- Dianxu Ren1,
- Marilyn Hravnak1
- 1School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- 2School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- 3Bloomberg Faculty of Nursing, University of Toronto and University Health Network, Toronto, Ontario, Canada
- Correspondence to Lora K Ott Indiana University of Pennsylvania 229 Johnson Hall Indiana, PA 15750
Contributors Study design: LO, MP, LH, SPC, SC, DR, MH; data collection: LO; data analysis and interpretation: LO, MP, DR, MH; drafting, critical revision and final approval of manuscript: LO, MP, LH, SPC, SC, MH.
- Accepted 24 January 2012
- Published Online First 2 March 2012
Objective We sought to identify the characteristics of patients who experience medical emergency team calls in the radiology department (MET-RD) and the relationship between these characteristics and patient outcomes.
Design/participants Retrospective review of 111 inpatient MET-RD calls (May 2008–April 2010).
Setting Academic medical centre with a well established MET system.
Measurements The characteristics of patients before, during and after transport to radiology were extracted from medical records and administrative databases. These characteristics were compared between patients with good and poor outcomes.
Main results The majority of patients who experience MET-RD calls had a Charlson Comorbidity Index ≥4 and were from non-intensive care units (60%). Almost half (43%) of MET-RD calls occurred during patients' first day in hospital. Patients commonly arrived with nasal cannula oxygen (38%), recent tachypnoea (28%) and tachycardia (34%). A minority (16%) fulfilled MET call criteria in the 12 h before the MET-RD. MET-RD etiologies were cardiac (41%), respiratory (29%) or neurological (25%), and occurred most frequently during CT (44%) and MRI (22%) testing. Post MET-RD, the majority of patients (70%) required a higher level of care. Death before discharge (25%) was associated with need for cardiovascular support prior to RD transport (p=0.02), need for RD monitoring (p=0.02) and need for heightened RD surveillance (p=0.04).
Conclusions The majority of patients who experienced MET-RD calls came from non-intensive care units, with comorbidities and vital sign alterations prior to arrival at the RD. Risk appeared to be increased for those requiring CT and MRI. These findings suggest that prior identification of a subset of patients at risk of instability in the RD may be possible.
- Patient safety
- medical emergency team
- patient outcomes
- intra-hospital transport
- patient safety
- hospital medicine
Linked article 000817
Funding Lora Ott is supported by NINR National Research Service Award (1F31NR012343-01) and the Leslie A. Hoffman Endowed Research Award 2010, Michael R Pinsky, MD by NHLBI mid-career development award (2K24 HL067181) and Sunday Clark is supported by NCRR NIH Roadmap for Medical Research (KL2 RR024154).
Competing interests None.
Ethics approval Ethics approval was provided by Institutional Review Board University of Pittsburgh.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data obtained in this study are the property of the principal researcher, the first named author.