Improving the utilization of medical crisis teams (Condition C) at an urban tertiary care hospital☆,☆☆
Section snippets
Setting
This experience is part of a larger, ongoing patient safety and quality improvement effort at the University of Pittsburgh Medical Center (UPMC) designed to: (1) improve responses to medical crises and (2) investigate medical crises to uncover and remediate processes of care that may have contributed.
UPMC Presbyterian University Hospital (UPMC-P) is a tertiary care, university hospital complex with 567 licensed beds, with 116 critical care beds in 11 intensive care units. There are no
Results
Over a 3-year period, interventions increased the use of organized responses to medical crises (Condition C) and decreased the number of disorganized responses (sequential stat pages).
Discussion
At an urban tertiary care hospital, it was possible to increase the use of a medical emergency team (Condition C at our institution) through institutional interventions. Before these interventions, in our hospital (as in most hospitals in the United States), stat paging was commonly used to immediately summon additional caregivers to the patient's bedside during medical crises (eg, more experienced nurses, a physician, a respiratory therapist, and so forth). In many cases, especially when
Conclusion
Our report focuses on the methodology used to foster behavior change. The rationales for the change are presented and focus on providing a more reliable and expert response to patient crisis. We show that a hospital can change recognition of and response to crisis. We suggest, but do not show, that the change desired may improve outcome.
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Address reprint requests to Michael A. DeVita, MD, C-111 UPMC Presbyterian Hospital, 200 Lothrop St, Pittsburgh, PA 15213; e-mail: [email protected].
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0883-9441/03/1802-0003$30.00/0